01D1061758 CLIA NUMBER - ALABAMA PEDIATRIC GASTROENTEROLOGY PC

Laboratory Demographics

CLIA Number: 01D1061758

Facility Name: ALABAMA PEDIATRIC GASTROENTEROLOGY PC

Facility Address:
2001 FIELDSTOWN ROAD
MOUNT OLIVE, AL
ZIP 35117
Get Directions

Facility Phone Number: 205 933-5744

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1003901240

Taxonomy: 2080P0206X - Pediatrics
A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs.

CLIA Record

Field Name	Field Value
CLIA Number	01D1061758
LAB Type	Physician Office
Facility Name	ALABAMA PEDIATRIC GASTROENTEROLOGY PC
Street	2001 FIELDSTOWN ROAD
City	MOUNT OLIVE
State	AL
ZIP	35117
Phone	205 933-5744
CertificateType	4
CertificateEffectiveDate	11/28/2022
CertificateExpirationDate	11/27/2024
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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