01D0304172 CLIA NUMBER - MONTGOMERY INTERNIST

Laboratory Demographics

  • CLIA Code: 01D0304172
  • Facility Name: MONTGOMERY INTERNIST
  • Facility Address: 1722 PINE STREET SUITE 1002
    MONTGOMERY, AL
    ZIP 36106
  • Facility Phone: 334 263-4444
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WILLIAM D. SMITH
  • NPI Number: 1336215748
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 01D0304172
LAB Type Physician Office
Facility Name MONTGOMERY INTERNIST
Street 1722 PINE STREET SUITE 1002
City MONTGOMERY
State AL
ZIP 36106
Phone 334 263-4444
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/11/2024
Certificate Expiration Date 4/10/2026
Facility Type Physician Office
Lab Director WILLIAM D. SMITH

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This page was last updated on: 6/4/2025