01D2020982 CLIA NUMBER - EASTERN SHORE INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 01D2020982
  • Facility Name: EASTERN SHORE INTERNAL MEDICINE
  • Facility Address: 24220 US HWY 98
    FAIRHOPE, AL
    ZIP 36532
  • Facility Phone: 251 990-1770
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RICHARD L. SNELLGROVE
  • NPI Number: 1891090403
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 01D2020982
LAB Type Physician Office
Facility Name EASTERN SHORE INTERNAL MEDICINE
Street 24220 US HWY 98
City FAIRHOPE
State AL
ZIP 36532
Phone 251 990-1770
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/3/2025
Certificate Expiration Date 3/2/2027
Facility Type Physician Office
Lab Director RICHARD L. SNELLGROVE

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