01D0303729 CLIA NUMBER - LAKESHORE FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 01D0303729
  • Facility Name: LAKESHORE FAMILY PRACTICE
  • Facility Address: 2308 HOMER CLAYTON DR
    GUNTERSVILLE, AL
    ZIP 35976
  • Facility Phone: 256 582-2581
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. STEPHEN B. HENDERSON
  • NPI Number: 1578644324
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 01D0303729
LAB Type Physician Office
Facility Name LAKESHORE FAMILY PRACTICE
Street 2308 HOMER CLAYTON DR
City GUNTERSVILLE
State AL
ZIP 35976
Phone 256 582-2581
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director DR. STEPHEN B. HENDERSON

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This page was last updated on: 9/29/2025