01D0953359 CLIA NUMBER - GRANT PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 01D0953359
  • Facility Name: GRANT PRIMARY CARE
  • Facility Address: 4500 MAIN ST
    GRANT, AL
    ZIP 35747
  • Facility Phone: 256 728-8600
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AMANDA L. STOREY
  • NPI Number: 1104149442
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 01D0953359
LAB Type Physician Office
Facility Name GRANT PRIMARY CARE
Street 4500 MAIN ST
City GRANT
State AL
ZIP 35747
Phone 256 728-8600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/17/2025
Certificate Expiration Date 1/16/2027
Facility Type Physician Office
Lab Director AMANDA L. STOREY

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