01D0983120 CLIA NUMBER - UROLOGY CLINIC OF SOUTH ALABAMA LLC

Laboratory Demographics

CLIA Number: 01D0983120

Facility Name: UROLOGY CLINIC OF SOUTH ALABAMA LLC

Facility Address:
215 MEDICAL PARK DRIVE SUITE 2
ANDALUSIA, AL
ZIP 36420
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Facility Phone Number: 334 427-7218

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1013100627

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	01D0983120
LAB Type	Physician Office
Facility Name	UROLOGY CLINIC OF SOUTH ALABAMA LLC
Street	215 MEDICAL PARK DRIVE SUITE 2
City	ANDALUSIA
State	AL
ZIP	36420
Phone	334 427-7218
CertificateType	3
CertificateEffectiveDate	2/14/2023
CertificateExpirationDate	2/13/2025
FacilityType	PPMP

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