01D1018695 CLIA NUMBER - CENTER STAR FAMILY PRACTICE

Laboratory Demographics

CLIA Number: 01D1018695

Facility Name: CENTER STAR FAMILY PRACTICE

Facility Address:
6459 HIGHWAY 72
KILLEN, AL
ZIP 35645
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Facility Phone Number: 256 272-0275

Facility Type: Practitioner Other

Certificate Type: Microscopy

NPI Number: 1801950167

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	01D1018695
LAB Type	Practitioner Other
Facility Name	CENTER STAR FAMILY PRACTICE
Street	6459 HIGHWAY 72
City	KILLEN
State	AL
ZIP	35645
Phone	256 272-0275
CertificateType	3
CertificateEffectiveDate	10/29/2023
CertificateExpirationDate	10/28/2025
FacilityType	PPMP

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