01D0864261 CLIA NUMBER - JON R MOODY LAB

Laboratory Demographics

  • CLIA Code: 01D0864261
  • Facility Name: JON R MOODY LAB
  • Facility Address: 420 LOWELL DR SE
    HUNTSVILLE, AL
    ZIP 35801
  • Facility Phone: 256 535-5964
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JON R. MOODY
  • NPI Number: 1164404513
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 01D0864261
LAB Type Physician Office
Facility Name JON R MOODY LAB
Street 420 LOWELL DR SE
City HUNTSVILLE
State AL
ZIP 35801
Phone 256 535-5964
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 6/5/2024
Certificate Expiration Date 6/4/2026
Facility Type Physician Office
Lab Director JON R. MOODY

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This page was last updated on: 9/29/2025