01D0305481 CLIA NUMBER - IMC DIAGNOSTIC AND MEDICAL CLINIC

Laboratory Demographics

  • Code: 01D0305481
  • Facility Name: IMC DIAGNOSTIC AND MEDICAL CLINIC
  • Facility Address: 1700 SPRINGHILL AVE SUITE 100
    MOBILE, AL
    ZIP 36604
  • Facility Phone: 251 435-1283
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • NPI Number: 1447201066
  • Taxonomy: 207R00000X - Internal Medicine
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CLIA Record

Field Name Field Value
CLIA Number 01D0305481
LAB Type Physician Office
Facility Name IMC DIAGNOSTIC AND MEDICAL CLINIC
Street 1700 SPRINGHILL AVE SUITE 100
City MOBILE
State AL
ZIP 36604
Phone 251 435-1283
Certificate Type 2
Certificate Effective Date 3/23/2022
Certificate Expiration Date 4/30/2024
Facility Type Compliance

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