01D2032972 CLIA NUMBER - FORT MITCHELL CLINIC PC

Laboratory Demographics

  • CLIA Code: 01D2032972
  • Facility Name: FORT MITCHELL CLINIC PC
  • Facility Address: 2 GILMORE RD
    FORT MITCHELL, AL
    ZIP 36856
  • Facility Phone: 334 664-1960
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: RITU CHANDRA
  • NPI Number: 1235682535
  • Taxonomy: 261QD0000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 01D2032972
LAB Type Rural Health Clinic
Facility Name FORT MITCHELL CLINIC PC
Street 2 GILMORE RD
City FORT MITCHELL
State AL
ZIP 36856
Phone 334 664-1960
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/18/2023
Certificate Expiration Date 11/17/2025
Facility Type Rural Health Clinic
Lab Director RITU CHANDRA

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