01D2073262 CLIA NUMBER - PICKENS COUNTY FAMILY PRACTICE CENTER

Laboratory Demographics

  • CLIA Code: 01D2073262
  • Facility Name: PICKENS COUNTY FAMILY PRACTICE CENTER
  • Facility Address: 27340 HWY 86
    GORDO, AL
    ZIP 35466
  • Facility Phone: 205 758-6647
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: ROBERT VICE
  • NPI Number: 1467506469
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 01D2073262
LAB Type Federally Qualified Health Center
Facility Name PICKENS COUNTY FAMILY PRACTICE CENTER
Street 27340 HWY 86
City GORDO
State AL
ZIP 35466
Phone 205 758-6647
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/13/2024
Certificate Expiration Date 2/12/2026
Facility Type Federally Qualified Health Center
Lab Director ROBERT VICE

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