01D2026580 CLIA NUMBER - EAST MONTGOMERY PRIMARY MEDICINE

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Laboratory Demographics

CLIA Number: 01D2026580

Facility Name: EAST MONTGOMERY PRIMARY MEDICINE

Facility Address:
470 TAYLOR ROAD, SUITE 310
MONTGOMERY, AL
ZIP 36117
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Facility Phone Number: 334 286-2891

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1326246448

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	01D2026580
LAB Type	Physician Office
Facility Name	EAST MONTGOMERY PRIMARY MEDICINE
Street	470 TAYLOR ROAD, SUITE 310
City	MONTGOMERY
State	AL
ZIP	36117
Phone	334 286-2891
CertificateType	4
CertificateEffectiveDate	7/5/2023
CertificateExpirationDate	7/4/2025
FacilityType	Waiver

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