01D0713587 CLIA NUMBER - BESSEMER BOYS GROUP HOME

Laboratory Demographics

CLIA Number: 01D0713587

Facility Name: BESSEMER BOYS GROUP HOME

Facility Address:
1631 2ND AVENUE NORTH
BESSEMER, AL
ZIP 35020
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Facility Phone Number: 205 838-2077

Facility Type: Other - BEHAVIORAL HEALTH GROUP

Certificate Type: Waiver

NPI Number: 1043756513

Taxonomy: 213ES0131X - Podiatrist

CLIA Record

Field Name Field Value
CLIA Number 01D0713587
LAB Type Other - BEHAVIORAL HEALTH GROUP
Facility Name BESSEMER BOYS GROUP HOME
Street 1631 2ND AVENUE NORTH
City BESSEMER
State AL
ZIP 35020
Phone 205 838-2077
CertificateType 4
CertificateEffectiveDate 9/1/2022
CertificateExpirationDate 8/31/2024
FacilityType Waiver

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