01D2026580 CLIA NUMBER - EAST MONTGOMERY PRIMARY MEDICINE

Laboratory Demographics

  • CLIA Code: 01D2026580
  • Facility Name: EAST MONTGOMERY PRIMARY MEDICINE
  • Facility Address: 470 TAYLOR ROAD, SUITE 310
    MONTGOMERY, AL
    ZIP 36117
  • Facility Phone: 334 747-2899
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LOUISA TOLENTINO
  • NPI Number: 1326246448
  • Taxonomy: 207Q00000X - Family Medicine

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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 334 747-2899
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/5/2025
Certificate Expiration Date 7/4/2027
Facility Type Physician Office
Lab Director LOUISA TOLENTINO

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