01D0689512 CLIA NUMBER - SOUTHERN CLINIC PC

Laboratory Demographics

  • CLIA Code: 01D0689512
  • Facility Name: SOUTHERN CLINIC PC
  • Facility Address: 201 DOCTORS DR
    DOTHAN, AL
    ZIP 36301
  • Facility Phone: 334 794-6611
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: MARIEN TAVAREZ OLMOS
  • NPI Number: 1053410480
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 01D0689512
LAB Type Physician Office
Facility Name SOUTHERN CLINIC PC
Street 201 DOCTORS DR
City DOTHAN
State AL
ZIP 36301
Phone 334 794-6611
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 5/4/2025
Certificate Expiration Date 5/3/2027
Facility Type Physician Office
Lab Director MARIEN TAVAREZ OLMOS

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This page was last updated on: 9/29/2025