01D1066029 CLIA NUMBER - ALABAMA OUTPATIENT SURGERY CENTER

Laboratory Demographics

CLIA Number: 01D1066029

Facility Name: ALABAMA OUTPATIENT SURGERY CENTER

Facility Address:
1323 SUMMIT DRIVE
JASPER, AL
ZIP 35501
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Facility Phone Number: 205 387-4404

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1043367196

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	01D1066029
LAB Type	Ambulatory Surgery Center
Facility Name	ALABAMA OUTPATIENT SURGERY CENTER
Street	1323 SUMMIT DRIVE
City	JASPER
State	AL
ZIP	35501
Phone	205 387-4404
CertificateType	4
CertificateEffectiveDate	3/14/2023
CertificateExpirationDate	3/13/2025
FacilityType	Waiver

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