01D0996053 CLIA NUMBER - CLANTON FAMILY HEALTH CENTER

Laboratory Demographics

CLIA Number: 01D0996053

Facility Name: CLANTON FAMILY HEALTH CENTER

Facility Address:
107 MEDICAL CENTER DRIVE
CLANTON, AL
ZIP 35045
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Facility Phone Number: 334 420-5001

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1700808664

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	01D0996053
LAB Type	Federally Qualified Health Center
Facility Name	CLANTON FAMILY HEALTH CENTER
Street	107 MEDICAL CENTER DRIVE
City	CLANTON
State	AL
ZIP	35045
Phone	334 420-5001
CertificateType	4
CertificateEffectiveDate	1/12/2024
CertificateExpirationDate	1/11/2026
FacilityType	Waiver

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