01D0304818 CLIA NUMBER - DOTHAN SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 01D0304818
  • Facility Name: DOTHAN SURGERY CENTER
  • Facility Address: 1450 ROSS CLARK CIR SE SUITE 4
    DOTHAN, AL
    ZIP 36301
  • Facility Phone: 334 793-3442
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: TIM GANNON MD
  • NPI Number: 1003815242
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 01D0304818
LAB Type Ambulatory Surgery Center
Facility Name DOTHAN SURGERY CENTER
Street 1450 ROSS CLARK CIR SE SUITE 4
City DOTHAN
State AL
ZIP 36301
Phone 334 793-3442
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Ambulatory Surgery Center
Lab Director TIM GANNON MD

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