01D0674205 CLIA NUMBER - PHYSICIANS CHOICE DIALYSIS-MONTGOMERY

Laboratory Demographics

CLIA Number: 01D0674205

Facility Name: PHYSICIANS CHOICE DIALYSIS-MONTGOMERY

Facility Address:
1001 FOREST AVENUE
MONTGOMERY, AL
ZIP 36106
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Facility Phone Number: (334) 269-9416

Facility Type: END STAGE RENAL DISEASE DIALYSIS

Certificate Type: Waiver

NPI Number: 1760446199

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	01D0674205
LAB Type	END STAGE RENAL DISEASE DIALYSIS
Facility Name	PHYSICIANS CHOICE DIALYSIS-MONTGOMERY
Street	1001 FOREST AVENUE
City	MONTGOMERY
State	AL
ZIP	36106
Phone	(334) 269-9416

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