01D0967316 CLIA NUMBER - CHISHOLM FAMILY HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 01D0967316
  • Facility Name: CHISHOLM FAMILY HEALTH CENTER
  • Facility Address: 100 EAST VANDIVER BLVD
    MONTGOMERY, AL
    ZIP 36110
  • Facility Phone: 334 420-5001
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: GEORGE G. THOMAS
  • NPI Number: 1538181490
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 01D0967316
LAB Type Federally Qualified Health Center
Facility Name CHISHOLM FAMILY HEALTH CENTER
Street 100 EAST VANDIVER BLVD
City MONTGOMERY
State AL
ZIP 36110
Phone 334 420-5001
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/12/2024
Certificate Expiration Date 1/11/2026
Facility Type Federally Qualified Health Center
Lab Director GEORGE G. THOMAS

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This page was last updated on: 6/4/2025