01D0874024 CLIA NUMBER - PHILIP A ROTH JR MD PC

Laboratory Demographics

  • CLIA Code: 01D0874024
  • Facility Name: PHILIP A ROTH JR MD PC
  • Facility Address: 2089 CECIL ASHBURN DR SUITE 101
    HUNTSVILLE, AL
    ZIP 35802
  • Facility Phone: 256 533-3966
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PHILIP A. ROTH
  • NPI Number: 1710968383
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 01D0874024
LAB Type Physician Office
Facility Name PHILIP A ROTH JR MD PC
Street 2089 CECIL ASHBURN DR SUITE 101
City HUNTSVILLE
State AL
ZIP 35802
Phone 256 533-3966
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/14/2025
Certificate Expiration Date 3/13/2027
Facility Type Physician Office
Lab Director PHILIP A. ROTH

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