01D0305025 CLIA NUMBER - ROBERTS CLINIC

Laboratory Demographics

  • CLIA Code: 01D0305025
  • Facility Name: ROBERTS CLINIC
  • Facility Address: 106 EDWINA ST
    EVERGREEN, AL
    ZIP 36401
  • Facility Phone: 251 578-4300
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARK A. ROBERTS
  • NPI Number: 1952466211
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 01D0305025
LAB Type Physician Office
Facility Name ROBERTS CLINIC
Street 106 EDWINA ST
City EVERGREEN
State AL
ZIP 36401
Phone 251 578-4300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/21/2024
Certificate Expiration Date 5/20/2026
Facility Type Physician Office
Lab Director MARK A. ROBERTS

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