01D0301960 CLIA NUMBER - PICKENS COUNTY PRIMARY CARE PC

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Laboratory Demographics

CLIA Number: 01D0301960

Facility Name: PICKENS COUNTY PRIMARY CARE PC

Facility Address:
514 10TH AVENUE SW
REFORM, AL
ZIP 35481
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Facility Phone Number: (205) 375-6251

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1104183334

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	01D0301960
LAB Type	PHYSICIAN OFFICE
Facility Name	PICKENS COUNTY PRIMARY CARE PC
Street	514 10TH AVENUE SW
City	REFORM
State	AL
ZIP	35481
Phone	(205) 375-6251

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This page was last updated on: 5/11/2023