01D0674205 CLIA NUMBER - PHYSICIANS CHOICE DIALYSIS-MONTGOMERY

Laboratory Demographics

  • CLIA Code: 01D0674205
  • Facility Name: PHYSICIANS CHOICE DIALYSIS-MONTGOMERY
  • Facility Address: 1001 FOREST AVENUE
    MONTGOMERY, AL
    ZIP 36106
  • Facility Phone: 334 269-9416
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DR. MICHAEL BRODER MD
  • NPI Number: 1760446199
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 01D0674205
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name PHYSICIANS CHOICE DIALYSIS-MONTGOMERY
Street 1001 FOREST AVENUE
City MONTGOMERY
State AL
ZIP 36106
Phone 334 269-9416
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DR. MICHAEL BRODER MD

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This page was last updated on: 6/4/2025