01D0664095 CLIA NUMBER - CENTRAL ALABAMA ENT ASSOC

Laboratory Demographics

  • CLIA Code: 01D0664095
  • Facility Name: CENTRAL ALABAMA ENT ASSOC
  • Facility Address: 6980 WINTON BLOUNT BOULEVARD
    MONTGOMERY, AL
    ZIP 36117
  • Facility Phone: 334 277-0489
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WALLACE C. VAUGHAN JR MD
  • NPI Number: 1982764007
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 01D0664095
LAB Type Physician Office
Facility Name CENTRAL ALABAMA ENT ASSOC
Street 6980 WINTON BLOUNT BOULEVARD
City MONTGOMERY
State AL
ZIP 36117
Phone 334 277-0489
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/19/2025
Certificate Expiration Date 9/18/2027
Facility Type Physician Office
Lab Director WALLACE C. VAUGHAN JR MD

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