01D1004060 CLIA NUMBER - MCCOLLOUGH PLASTIC SURGERY CLINIC

Laboratory Demographics

  • CLIA Code: 01D1004060
  • Facility Name: MCCOLLOUGH PLASTIC SURGERY CLINIC
  • Facility Address: 350 CYPRESS BEND DRIVE
    GULF SHORES, AL
    ZIP 36542
  • Facility Phone: 251 967-7673
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: E GAYLON MCCOLLOUGH
  • NPI Number: 1043439128
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 01D1004060
LAB Type Physician Office
Facility Name MCCOLLOUGH PLASTIC SURGERY CLINIC
Street 350 CYPRESS BEND DRIVE
City GULF SHORES
State AL
ZIP 36542
Phone 251 967-7673
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/18/2024
Certificate Expiration Date 9/17/2026
Facility Type Physician Office
Lab Director E GAYLON MCCOLLOUGH

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This page was last updated on: 9/29/2025