01D1083033 CLIA NUMBER - WIREGRASS SURGICAL ASSOCIATES PC DBA WIREGRASS CLINIC LLC

Laboratory Demographics

  • CLIA Code: 01D1083033
  • Facility Name: WIREGRASS SURGICAL ASSOCIATES PC DBA WIREGRASS CLINIC LLC
  • Facility Address: 4300 WEST MAIN STREET SUITE 24
    DOTHAN, AL
    ZIP 36305
  • Facility Phone: 334 793-1534
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STEVEN M. FENDLEY
  • NPI Number: 1750387833
  • Taxonomy: 2086S0129X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 01D1083033
LAB Type Physician Office
Facility Name WIREGRASS SURGICAL ASSOCIATES PC DBA WIREGRASS CLINIC LLC
Street 4300 WEST MAIN STREET SUITE 24
City DOTHAN
State AL
ZIP 36305
Phone 334 793-1534
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/24/2024
Certificate Expiration Date 4/23/2026
Facility Type Physician Office
Lab Director STEVEN M. FENDLEY

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