01D0974184 CLIA NUMBER - EASTERN SHORE HEALTH CENTER LLC

Laboratory Demographics

CLIA Number: 01D0974184

Facility Name: EASTERN SHORE HEALTH CENTER LLC

Facility Address:
908 PLANTATION BLVD
FAIRHOPE, AL
ZIP 36532
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Facility Phone Number: 251 990-2292

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1447459748

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	01D0974184
LAB Type	Physician Office
Facility Name	EASTERN SHORE HEALTH CENTER LLC
Street	908 PLANTATION BLVD
City	FAIRHOPE
State	AL
ZIP	36532
Phone	251 990-2292
CertificateType	4
CertificateEffectiveDate	5/31/2022
CertificateExpirationDate	5/30/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024