01D0990448 CLIA NUMBER - SOUTH ALABAMA OUTPATIENT SERVICES

Laboratory Demographics

  • CLIA Code: 01D0990448
  • Facility Name: SOUTH ALABAMA OUTPATIENT SERVICES
  • Facility Address: 201 EAST WATTS STREET
    ENTERPRISE, AL
    ZIP 36330
  • Facility Phone: 334 393-5474
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: J M. MCQUEEN MD
  • NPI Number: 1013924133
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 01D0990448
LAB Type Ambulatory Surgery Center
Facility Name SOUTH ALABAMA OUTPATIENT SERVICES
Street 201 EAST WATTS STREET
City ENTERPRISE
State AL
ZIP 36330
Phone 334 393-5474
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/22/2023
Certificate Expiration Date 8/21/2025
Facility Type Ambulatory Surgery Center
Lab Director J M. MCQUEEN MD

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