01D0671854 CLIA NUMBER - PHYSICIANS CHOICE DIALYSIS-PRATTVILLE

Laboratory Demographics

  • Code: 01D0671854
  • Facility Name: PHYSICIANS CHOICE DIALYSIS-PRATTVILLE
  • Facility Address: 600 MCQUEEN SMITH ROAD
    PRATTVILLE, AL
    ZIP 36066
  • Facility Phone: 334 358-1576
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • NPI Number: 1902860331
  • Taxonomy: 261QE0700X - Clinic/Center
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CLIA Record

Field Name Field Value
CLIA Number 01D0671854
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name PHYSICIANS CHOICE DIALYSIS-PRATTVILLE
Street 600 MCQUEEN SMITH ROAD
City PRATTVILLE
State AL
ZIP 36066
Phone 334 358-1576
Certificate Type 4
Certificate Effective Date 9/1/2022
Certificate Expiration Date 8/31/2024
Facility Type Waiver

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