01D2074962 CLIA NUMBER - JACKSONVILLE FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 01D2074962
  • Facility Name: JACKSONVILLE FAMILY MEDICINE
  • Facility Address: 1465 1ST AVE SW, SUITE A
    JACKSONVILLE, AL
    ZIP 36265
  • Facility Phone: 256 435-2358
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ADAMS S. BLAGBURN
  • NPI Number: 1316312028
  • Taxonomy: 207P00000X - Emergency Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 01D2074962
LAB Type Physician Office
Facility Name JACKSONVILLE FAMILY MEDICINE
Street 1465 1ST AVE SW, SUITE A
City JACKSONVILLE
State AL
ZIP 36265
Phone 256 435-2358
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/19/2025
Certificate Expiration Date 8/18/2027
Facility Type Physician Office
Lab Director ADAMS S. BLAGBURN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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