01D0304855 CLIA NUMBER - PRIMECARE OF DOTHAN

Laboratory Demographics

  • Code: 01D0304855
  • Facility Name: PRIMECARE OF DOTHAN
  • Facility Address: 4126 WEST MAIN STREET
    DOTHAN, AL
    ZIP 36305
  • Facility Phone: 334 793-2120
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • NPI Number: 1487726626
  • Taxonomy: 261QP2300X - Clinic/Center
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CLIA Record

Field Name Field Value
CLIA Number 01D0304855
LAB Type Physician Office
Facility Name PRIMECARE OF DOTHAN
Street 4126 WEST MAIN STREET
City DOTHAN
State AL
ZIP 36305
Phone 334 793-2120
Certificate Type 1
Certificate Effective Date 12/14/2023
Certificate Expiration Date 12/13/2025
Facility Type Accreditation

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This page was last updated on: 4/23/2024