01D1107860 CLIA NUMBER - WIREGRASS WELLNESS CENTER LLC

Laboratory Demographics

  • CLIA Code: 01D1107860
  • Facility Name: WIREGRASS WELLNESS CENTER LLC
  • Facility Address: 201 REGENCY CT
    DOTHAN, AL
    ZIP 36305
  • Facility Phone: 334 673-8869
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOHN C. STRUNK
  • NPI Number: 1013117167
  • Taxonomy: 2084P0800X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 01D1107860
LAB Type Physician Office
Facility Name WIREGRASS WELLNESS CENTER LLC
Street 201 REGENCY CT
City DOTHAN
State AL
ZIP 36305
Phone 334 673-8869
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/13/2023
Certificate Expiration Date 11/12/2025
Facility Type Physician Office
Lab Director JOHN C. STRUNK

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