01D0695986 CLIA NUMBER - SOUTHEAST HEALTH UROLOGY

Laboratory Demographics

CLIA Number: 01D0695986

Facility Name: SOUTHEAST HEALTH UROLOGY

Facility Address:
1118 ROSS CLARK CIRCLE SUITE 500
DOTHAN, AL
ZIP 36301
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Facility Phone Number: 334 793-8176

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1811070410

Taxonomy: 213E00000X - Podiatrist
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.

CLIA Record

Field Name	Field Value
CLIA Number	01D0695986
LAB Type	Physician Office
Facility Name	SOUTHEAST HEALTH UROLOGY
Street	1118 ROSS CLARK CIRCLE SUITE 500
City	DOTHAN
State	AL
ZIP	36301
Phone	334 793-8176
CertificateType	3
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	PPMP

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