01D0641778 CLIA NUMBER - WEST MOBILE MEDICAL GROUP

Laboratory Demographics

CLIA Number: 01D0641778

Facility Name: WEST MOBILE MEDICAL GROUP

Facility Address:
610 PROVIDENCE PARK DR, E BLDG 1 SUITE 101
MOBILE, AL
ZIP 36695
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Facility Phone Number: (251) 378-3900

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1356495378

Taxonomy: 111N00000X - Chiropractor
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

CLIA Record

Field Name Field Value
CLIA Number 01D0641778
LAB Type PHYSICIAN OFFICE
Facility Name WEST MOBILE MEDICAL GROUP
Street 610 PROVIDENCE PARK DR, E BLDG 1 SUITE 101
City MOBILE
State AL
ZIP 36695
Phone (251) 378-3900

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This page was last updated on: 3/23/2022