01D0997007 CLIA NUMBER - KOPYTA INTERNAL MEDICINE PC

Laboratory Demographics

CLIA Number: 01D0997007

Facility Name: KOPYTA INTERNAL MEDICINE PC

Facility Address:
312 SAND MOUNTAIN DRIVE SE
ALBERTVILLE, AL
ZIP 35950
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Facility Phone Number: 256 891-4577

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1639476252

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	01D0997007
LAB Type	Physician Office
Facility Name	KOPYTA INTERNAL MEDICINE PC
Street	312 SAND MOUNTAIN DRIVE SE
City	ALBERTVILLE
State	AL
ZIP	35950
Phone	256 891-4577
CertificateType	4
CertificateEffectiveDate	3/4/2024
CertificateExpirationDate	3/3/2026
FacilityType	Waiver

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