01D0692392 CLIA NUMBER - Mostellar Medical Center

Laboratory Demographics

CLIA Number: 01D0692392

Facility Name: Mostellar Medical Center

Facility Address:
12701 Padgett Switch Rd,
Irvington, AL
ZIP 36544
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Facility Phone Number: (251) 824-2174

Facility Type: FEDERALLY QUALIFIED HEALTH CENTER

Certificate Type: Waiver

NPI Number: 1396794426

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name Field Value
CLIA Number 01D0692392
LAB Type FEDERALLY QUALIFIED HEALTH CENTER
Facility Name Mostellar Medical Center
Street 12701 Padgett Switch Rd,
City Irvington
State AL
ZIP 36544
Phone 2518242174

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This page was last updated on: 5/19/2019