01D0304795 CLIA NUMBER - RENAL-HYPERTENSION CLNC

Laboratory Demographics

  • CLIA Code: 01D0304795
  • Facility Name: RENAL-HYPERTENSION CLNC
  • Facility Address: 1540 E MAIN
    DOTHAN, AL
    ZIP 36301
  • Facility Phone: 334 793-2618
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAVINDRANATH KANTAMNENI
  • NPI Number: 1063526663
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 01D0304795
LAB Type Physician Office
Facility Name RENAL-HYPERTENSION CLNC
Street 1540 E MAIN
City DOTHAN
State AL
ZIP 36301
Phone 334 793-2618
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/9/2024
Certificate Expiration Date 9/8/2026
Facility Type Physician Office
Lab Director RAVINDRANATH KANTAMNENI

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This page was last updated on: 3/20/2025