01D0304757 CLIA NUMBER - DOTHAN PEDIATRIC CLINIC

Laboratory Demographics

  • CLIA Code: 01D0304757
  • Facility Name: DOTHAN PEDIATRIC CLINIC
  • Facility Address: 126 CLINIC DRIVE
    DOTHAN, AL
    ZIP 36303
  • Facility Phone: 334 793-1881
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: ROBERT BENAK
  • NPI Number: 1447823877
  • Taxonomy: 208000000X - Pediatrics

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 01D0304757
LAB Type Physician Office
Facility Name DOTHAN PEDIATRIC CLINIC
Street 126 CLINIC DRIVE
City DOTHAN
State AL
ZIP 36303
Phone 334 793-1881
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 12/23/2023
Certificate Expiration Date 12/22/2025
Facility Type Physician Office
Lab Director ROBERT BENAK

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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