01D0304136 CLIA NUMBER - JACKSON FAMILY PRACTICE

Laboratory Demographics

CLIA Number: 01D0304136

Facility Name: JACKSON FAMILY PRACTICE

Facility Address:
1801 PINE STREET SUITE 301 ATTN KELIN PENNEY
MONTGOMERY, AL
ZIP 36106
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Facility Phone Number: (334) 265-5577

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1093870339

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	01D0304136
LAB Type	PHYSICIAN OFFICE
Facility Name	JACKSON FAMILY PRACTICE
Street	1801 PINE STREET SUITE 301 ATTN KELIN PENNEY
City	MONTGOMERY
State	AL
ZIP	36106
Phone	(334) 265-5577

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