01D0683115 CLIA NUMBER - Dr Keith A Dismukes

Laboratory Demographics

CLIA Number: 01D0683115

Facility Name: Dr Keith A Dismukes

Facility Address:
202 Hwy 80 East
Demopolis, AL
ZIP 36732
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Facility Phone Number: (334) 289-0499

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1801161138

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name Field Value
CLIA Number 01D0683115
LAB Type PHYSICIAN OFFICE
Facility Name Dr Keith A Dismukes
Street 202 Hwy 80 East
City Demopolis
State AL
ZIP 36732
Phone (334) 289-0499

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This page was last updated on: 4/7/2021