01D0979180 CLIA NUMBER - CORE ENT, LLC

Laboratory Demographics

CLIA Number: 01D0979180

Facility Name: CORE ENT, LLC

Facility Address:
215 SOUTH 5TH STREET
GADSDEN, AL
ZIP 35901
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Facility Phone Number: 256 543-2867

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1649523044

Taxonomy: 207YX0905X - Otolaryngology
An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions.

CLIA Record

Field Name	Field Value
CLIA Number	01D0979180
LAB Type	Physician Office
Facility Name	CORE ENT, LLC
Street	215 SOUTH 5TH STREET
City	GADSDEN
State	AL
ZIP	35901
Phone	256 543-2867
CertificateType	4
CertificateEffectiveDate	10/16/2022
CertificateExpirationDate	10/15/2024
FacilityType	Waiver

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