01D0304378 CLIA NUMBER - MONTGOMERY SURGICAL CENTER LLC

Laboratory Demographics

  • CLIA Code: 01D0304378
  • Facility Name: MONTGOMERY SURGICAL CENTER LLC
  • Facility Address: 470 TAYLOR ROAD SUITE 100
    MONTGOMERY, AL
    ZIP 36117
  • Facility Phone: 334 284-9600
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ROBERT ANNIBALE
  • NPI Number: 1467758516
  • Taxonomy: 2084P0800X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 01D0304378
LAB Type Ambulatory Surgery Center
Facility Name MONTGOMERY SURGICAL CENTER LLC
Street 470 TAYLOR ROAD SUITE 100
City MONTGOMERY
State AL
ZIP 36117
Phone 334 284-9600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/19/2025
Certificate Expiration Date 5/18/2027
Facility Type Ambulatory Surgery Center
Lab Director ROBERT ANNIBALE

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