01D0305009 CLIA NUMBER - OZARK MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 01D0305009
  • Facility Name: OZARK MEDICAL CLINIC
  • Facility Address: 145 KATHERINE AVENUE
    OZARK, AL
    ZIP 36360
  • Facility Phone: 334 774-5116
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: CONNIE CHANDLER MD
  • NPI Number: 1598905101
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 01D0305009
LAB Type Physician Office
Facility Name OZARK MEDICAL CLINIC
Street 145 KATHERINE AVENUE
City OZARK
State AL
ZIP 36360
Phone 334 774-5116
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/16/2024
Certificate Expiration Date 8/15/2026
Facility Type Physician Office
Lab Director CONNIE CHANDLER MD

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