01D1026599 CLIA NUMBER - DOTHAN INTERNAL MEDICINE LLC

Laboratory Demographics

  • CLIA Code: 01D1026599
  • Facility Name: DOTHAN INTERNAL MEDICINE LLC
  • Facility Address: 200 PARKWEST CIRCLE, SUITE 2
    DOTHAN, AL
    ZIP 36303
  • Facility Phone: 334 699-2004
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RODNEY K. BEAUCHAMP
  • NPI Number: 1598822272
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 01D1026599
LAB Type Physician Office
Facility Name DOTHAN INTERNAL MEDICINE LLC
Street 200 PARKWEST CIRCLE, SUITE 2
City DOTHAN
State AL
ZIP 36303
Phone 334 699-2004
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/9/2024
Certificate Expiration Date 12/8/2026
Facility Type Physician Office
Lab Director RODNEY K. BEAUCHAMP

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