01D0931103 CLIA NUMBER - EASTGADSDEN CLINIC

Laboratory Demographics

  • CLIA Code: 01D0931103
  • Facility Name: EASTGADSDEN CLINIC
  • Facility Address: 1026 GOODYEAR AVE SUITE 300
    GADSDEN, AL
    ZIP 35903
  • Facility Phone: 256 492-8250
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JYOTHIPRASANNA TUMMALA
  • NPI Number: 1891733002
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 01D0931103
LAB Type Physician Office
Facility Name EASTGADSDEN CLINIC
Street 1026 GOODYEAR AVE SUITE 300
City GADSDEN
State AL
ZIP 35903
Phone 256 492-8250
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/23/2025
Certificate Expiration Date 7/22/2027
Facility Type Physician Office
Lab Director DR. JYOTHIPRASANNA TUMMALA

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