01D1047704 CLIA NUMBER - SOUTHERN CANCER CENTER PC

Laboratory Demographics

CLIA Number: 01D1047704

Facility Name: SOUTHERN CANCER CENTER PC

Facility Address:
29653 ANCHOR CROSS BLVD
DAPHNE, AL
ZIP 36526
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Facility Phone Number: (251) 625-6896

Facility Type: PHYSICIAN OFFICE

Certificate Type: Certificate of Compliance

NPI Number: 1578629556

Taxonomy: 207RH0003X - Internal Medicine
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

CLIA Record

Field Name	Field Value
CLIA Number	01D1047704
LAB Type	PHYSICIAN OFFICE
Facility Name	SOUTHERN CANCER CENTER PC
Street	29653 ANCHOR CROSS BLVD
City	DAPHNE
State	AL
ZIP	36526
Phone	(251) 625-6896

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This page was last updated on: 5/11/2023