01D0931869 CLIA NUMBER - JACK M ENGLERT MD

Laboratory Demographics

  • CLIA Code: 01D0931869
  • Facility Name: JACK M ENGLERT MD
  • Facility Address: 101 BOB WALLACE AVE STE D
    HUNTSVILLE, AL
    ZIP 35801
  • Facility Phone: 256 517-1507
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JACK M. ENGLERT MD
  • NPI Number: 1558324186
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 01D0931869
LAB Type Physician Office
Facility Name JACK M ENGLERT MD
Street 101 BOB WALLACE AVE STE D
City HUNTSVILLE
State AL
ZIP 35801
Phone 256 517-1507
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 11/1/2023
Certificate Expiration Date 10/31/2025
Facility Type Physician Office
Lab Director JACK M. ENGLERT MD

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