01D0303861 CLIA NUMBER - BOSC/ DR MARTIN WYBENGA

Laboratory Demographics

CLIA Number: 01D0303861

Facility Name: BOSC/ DR MARTIN WYBENGA

Facility Address:
564 N MEMORIAL DRIVE
PRATTVILLE, AL
ZIP 36066
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Facility Phone Number: (334) 358-2010

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

CLIA Record

Field Name Field Value
CLIA Number 01D0303861
LAB Type PHYSICIAN OFFICE
Facility Name BOSC/ DR MARTIN WYBENGA
Street 564 N MEMORIAL DRIVE
City PRATTVILLE
State AL
ZIP 36066
Phone (334) 358-2010

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This page was last updated on: 3/23/2022