01D0305251 CLIA NUMBER - FAIRHOPE GASTROENTEROLOGY, LLC

Laboratory Demographics

CLIA Number: 01D0305251

Facility Name: FAIRHOPE GASTROENTEROLOGY, LLC

Facility Address:
#3 MEDICAL PARK DRIVE
FAIRHOPE, AL
ZIP 36532
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Facility Phone Number: (251) 928-8804

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1578106621

Taxonomy: 261QM2500X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

CLIA Record

Field Name	Field Value
CLIA Number	01D0305251
LAB Type	PHYSICIAN OFFICE
Facility Name	FAIRHOPE GASTROENTEROLOGY, LLC
Street	#3 MEDICAL PARK DRIVE
City	FAIRHOPE
State	AL
ZIP	36532
Phone	(251) 928-8804

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This page was last updated on: 5/11/2023