01D1084432 CLIA NUMBER - AFFINITY PHYSICIAN

Laboratory Demographics

CLIA Number: 01D1084432

Facility Name: AFFINITY PHYSICIAN

Facility Address:
3686 GRANDVIEW PARKWAY, SUITE 820
BIRMINGHAM, AL
ZIP 35243
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Facility Phone Number: 205 971-4903

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1225698681

Taxonomy: 261QE0800X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	01D1084432
LAB Type	Physician Office
Facility Name	AFFINITY PHYSICIAN
Street	3686 GRANDVIEW PARKWAY, SUITE 820
City	BIRMINGHAM
State	AL
ZIP	35243
Phone	205 971-4903
CertificateType	2
CertificateEffectiveDate	10/23/2022
CertificateExpirationDate	10/22/2024
FacilityType	Compliance

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