01D2067055 CLIA NUMBER - PREVENTIVE CARE MEDICAL GROUP LLC

Laboratory Demographics

  • CLIA Code: 01D2067055
  • Facility Name: PREVENTIVE CARE MEDICAL GROUP LLC
  • Facility Address: 210 NORTH SPRING STREET WEST SUITE C
    TALLADEGA, AL
    ZIP 35160
  • Facility Phone: 256 362-0066
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. ANTHONY LESSA MD
  • NPI Number: 1780055319
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 01D2067055
LAB Type Physician Office
Facility Name PREVENTIVE CARE MEDICAL GROUP LLC
Street 210 NORTH SPRING STREET WEST SUITE C
City TALLADEGA
State AL
ZIP 35160
Phone 256 362-0066
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/8/2025
Certificate Expiration Date 10/7/2027
Facility Type Physician Office
Lab Director DR. ANTHONY LESSA MD

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