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	(251) 824-2174

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This page was last updated on: 5/11/2023