01D1073934 CLIA NUMBER - SOUTHSIDE ENDOCRINOLOGY

Laboratory Demographics

CLIA Number: 01D1073934

Facility Name: SOUTHSIDE ENDOCRINOLOGY

Facility Address:
1900 CRESTWOOD BLVD SUITE 201
IRONDALE, AL
ZIP 35210
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Facility Phone Number: 205 957-0034

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1528119781

Taxonomy: 207RE0101X - Internal Medicine
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

CLIA Record

Field Name	Field Value
CLIA Number	01D1073934
LAB Type	Physician Office
Facility Name	SOUTHSIDE ENDOCRINOLOGY
Street	1900 CRESTWOOD BLVD SUITE 201
City	IRONDALE
State	AL
ZIP	35210
Phone	205 957-0034
CertificateType	4
CertificateEffectiveDate	9/19/2023
CertificateExpirationDate	9/18/2025
FacilityType	Waiver

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