01D2021281 CLIA NUMBER - MADISON PRIMARY CARE LLC

Laboratory Demographics

  • CLIA Code: 01D2021281
  • Facility Name: MADISON PRIMARY CARE LLC
  • Facility Address: 400 SUN TEMPLE DR
    MADISON, AL
    ZIP 35758
  • Facility Phone: 256 774-5524
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ADEEL BODLA MD
  • NPI Number: 1902297690
  • Taxonomy: 1223P0700X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 01D2021281
LAB Type Physician Office
Facility Name MADISON PRIMARY CARE LLC
Street 400 SUN TEMPLE DR
City MADISON
State AL
ZIP 35758
Phone 256 774-5524
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/10/2025
Certificate Expiration Date 3/9/2027
Facility Type Physician Office
Lab Director ADEEL BODLA MD

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