01D1034123 CLIA NUMBER - ABC PEDIATRIC CLINIC LLC

Laboratory Demographics

  • CLIA Code: 01D1034123
  • Facility Name: ABC PEDIATRIC CLINIC LLC
  • Facility Address: 1900 MAIN AVENUE SW
    CULLMAN, AL
    ZIP 35055
  • Facility Phone: 256 734-3759
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARSENA K. STEWART
  • NPI Number: 1841495603
  • Taxonomy: 173000000X - Legal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 01D1034123
LAB Type Physician Office
Facility Name ABC PEDIATRIC CLINIC LLC
Street 1900 MAIN AVENUE SW
City CULLMAN
State AL
ZIP 35055
Phone 256 734-3759
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/24/2024
Certificate Expiration Date 11/23/2026
Facility Type Physician Office
Lab Director MARSENA K. STEWART

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