01D0699520 CLIA NUMBER - Bruce W Russell MD

Laboratory Demographics

CLIA Number: 01D0699520

Facility Name: Bruce W Russell MD

Facility Address:
Community Professional Ctr Ste Bryant Roa
Sumiton, AL
ZIP 35148
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Facility Phone Number: (205) 648-6637

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1447280300

Taxonomy: 208D00000X - General Practice

CLIA Record

Field Name Field Value
CLIA Number 01D0699520
LAB Type PHYSICIAN OFFICE
Facility Name Bruce W Russell MD
Street Community Professional Ctr Ste Bryant Roa
City Sumiton
State AL
ZIP 35148
Phone (205) 648-6637

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This page was last updated on: 4/7/2021