01D0689275 CLIA NUMBER - TALLASSEE FAMILY CARE

Laboratory Demographics

  • Code: 01D0689275
  • Facility Name: TALLASSEE FAMILY CARE
  • Facility Address: 115 HERREN HILL ROAD
    TALLASSEE, AL
    ZIP 36078
  • Facility Phone: 334 283-3477
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • NPI Number: 1114982360
  • Taxonomy: 207Q00000X - Family Medicine
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CLIA Record

Field Name Field Value
CLIA Number 01D0689275
LAB Type Physician Office
Facility Name TALLASSEE FAMILY CARE
Street 115 HERREN HILL ROAD
City TALLASSEE
State AL
ZIP 36078
Phone 334 283-3477
Certificate Type 4
Certificate Effective Date 2/16/2023
Certificate Expiration Date 2/15/2025
Facility Type Waiver

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