01D1087944 CLIA NUMBER - PATHWAY HEALTHCARE

Laboratory Demographics

CLIA Number: 01D1087944

Facility Name: PATHWAY HEALTHCARE

Facility Address:
2010 SOUTH POINT PARK CR STE 200
HUNTSVILLE, AL
ZIP 35801
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Facility Phone Number: 205 208-9312

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1013425503

Taxonomy: 207QA0401X - Family Medicine
A family medicine physician who specializes in the diagnosis and treatment of addictions.

CLIA Record

Field Name	Field Value
CLIA Number	01D1087944
LAB Type	Physician Office
Facility Name	PATHWAY HEALTHCARE
Street	2010 SOUTH POINT PARK CR STE 200
City	HUNTSVILLE
State	AL
ZIP	35801
Phone	205 208-9312
CertificateType	4
CertificateEffectiveDate	10/14/2023
CertificateExpirationDate	10/13/2025
FacilityType	Waiver

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