01D0684484 CLIA NUMBER - PRATTVILLE BAPT MED CTR CARDIOPULM LAB

Laboratory Demographics

  • CLIA Code: 01D0684484
  • Facility Name: PRATTVILLE BAPT MED CTR CARDIOPULM LAB
  • Facility Address: 124 SOUTH MEMORIAL DRIVE
    PRATTVILLE, AL
    ZIP 36068
  • Facility Phone: 334 361-4243
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Accreditation
  • Lab Director: DR. KENNETH NICHOLS
  • NPI Number: 1326184029
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 01D0684484
LAB Type Ancillary Testing Site in Health Care Center
Facility Name PRATTVILLE BAPT MED CTR CARDIOPULM LAB
Street 124 SOUTH MEMORIAL DRIVE
City PRATTVILLE
State AL
ZIP 36068
Phone 334 361-4243
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 11/4/2024
Certificate Expiration Date 11/3/2026
Facility Type Ancillary Testing Site in Health Care Center
Lab Director DR. KENNETH NICHOLS

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This page was last updated on: 3/20/2025