01D1012616 CLIA NUMBER - FRANK T CROCKETT MD

Laboratory Demographics

  • CLIA Code: 01D1012616
  • Facility Name: FRANK T CROCKETT MD
  • Facility Address: 2115 WEST MAIN STREET
    DOTHAN, AL
    ZIP 36301
  • Facility Phone: 334 793-6556
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: FRANK T. CROCKETT
  • NPI Number: 1942277215
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 01D1012616
LAB Type Physician Office
Facility Name FRANK T CROCKETT MD
Street 2115 WEST MAIN STREET
City DOTHAN
State AL
ZIP 36301
Phone 334 793-6556
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/15/2025
Certificate Expiration Date 5/14/2027
Facility Type Physician Office
Lab Director FRANK T. CROCKETT

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