01D2014300 CLIA NUMBER - MIBELLA GYNECOLOGY LLC

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Laboratory Demographics

CLIA Number: 01D2014300

Facility Name: MIBELLA GYNECOLOGY LLC

Facility Address:
3000 MEADOW LAKE DRIVE SUITE 101
BIRMINGHAM, AL
ZIP 35242
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Facility Phone Number: 205 995-1009

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1720393606

Taxonomy: 207VG0400X - Obstetrics & Gynecology
A physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	01D2014300
LAB Type	Physician Office
Facility Name	MIBELLA GYNECOLOGY LLC
Street	3000 MEADOW LAKE DRIVE SUITE 101
City	BIRMINGHAM
State	AL
ZIP	35242
Phone	205 995-1009
CertificateType	3
CertificateEffectiveDate	10/5/2022
CertificateExpirationDate	10/4/2024
FacilityType	PPMP

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