01D2049431 CLIA NUMBER - ALLSOUTH URGENT CARE CLINIC

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Laboratory Demographics

CLIA Number: 01D2049431

Facility Name: ALLSOUTH URGENT CARE CLINIC

Facility Address:
1052 ROSS CLARK CIRCLE
DOTHAN, AL
ZIP 36303
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Facility Phone Number: 334 340-2600

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1770733636

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	01D2049431
LAB Type	Physician Office
Facility Name	ALLSOUTH URGENT CARE CLINIC
Street	1052 ROSS CLARK CIRCLE
City	DOTHAN
State	AL
ZIP	36303
Phone	334 340-2600
CertificateType	4
CertificateEffectiveDate	11/6/2022
CertificateExpirationDate	11/5/2024
FacilityType	Waiver

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