01D0671486 CLIA NUMBER - POARCH BAND OF CREEK INDIANS HEALTH DEPARTMENT LAB

Laboratory Demographics

  • Code: 01D0671486
  • Facility Name: POARCH BAND OF CREEK INDIANS HEALTH DEPARTMENT LAB
  • Facility Address: 429 BUFORD ROLIN DRIVE
    ATMORE, AL
    ZIP 36502
  • Facility Phone: 251 368-9136
  • Facility Type: Other - CREEK INDIAN HEATH DEPART
  • Facility Type: Certificate of Compliance
  • NPI Number: 1336257575
  • Taxonomy: 152W00000X - Optometrist
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CLIA Record

Field Name Field Value
CLIA Number 01D0671486
LAB Type Other - CREEK INDIAN HEATH DEPART
Facility Name POARCH BAND OF CREEK INDIANS HEALTH DEPARTMENT LAB
Street 429 BUFORD ROLIN DRIVE
City ATMORE
State AL
ZIP 36502
Phone 251 368-9136
Certificate Type 2
Certificate Effective Date 6/15/2022
Certificate Expiration Date 6/14/2024
Facility Type Compliance

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