01D0302603 CLIA NUMBER - LAWRENCE MEDICAL CTR, COMPLETE FAMILY CARE MD PC

Laboratory Demographics

  • CLIA Code: 01D0302603
  • Facility Name: LAWRENCE MEDICAL CTR, COMPLETE FAMILY CARE MD PC
  • Facility Address: 94 MEDICAL CIRCLE
    MOULTON, AL
    ZIP 35650
  • Facility Phone: 256 974-9216
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: DR. SAMUEL N. GILLESPIE MD
  • NPI Number: 1750802906
  • Taxonomy: 251K00000X - Public Health or Welfare

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CLIA Record

Field Name Field Value
CLIA Number 01D0302603
LAB Type Rural Health Clinic
Facility Name LAWRENCE MEDICAL CTR, COMPLETE FAMILY CARE MD PC
Street 94 MEDICAL CIRCLE
City MOULTON
State AL
ZIP 35650
Phone 256 974-9216
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/22/2024
Certificate Expiration Date 8/21/2026
Facility Type Rural Health Clinic
Lab Director DR. SAMUEL N. GILLESPIE MD

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This page was last updated on: 3/20/2025