01D0968274 CLIA NUMBER - DECATUR AMBULATORY SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 01D0968274
  • Facility Name: DECATUR AMBULATORY SURGERY CENTER
  • Facility Address: 2828 HWY 31 SO
    DECATUR, AL
    ZIP 35603
  • Facility Phone: 256 340-1212
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: RAJU DANTHULURI MD
  • NPI Number: 1487018412
  • Taxonomy: 207L00000X - Anesthesiology

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CLIA Record

Field Name Field Value
CLIA Number 01D0968274
LAB Type Ambulatory Surgery Center
Facility Name DECATUR AMBULATORY SURGERY CENTER
Street 2828 HWY 31 SO
City DECATUR
State AL
ZIP 35603
Phone 256 340-1212
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/8/2023
Certificate Expiration Date 12/7/2025
Facility Type Ambulatory Surgery Center
Lab Director RAJU DANTHULURI MD

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