01D2081262 CLIA NUMBER - RURAL PRIMARY CARE SOUTH INC

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Laboratory Demographics

CLIA Number: 01D2081262

Facility Name: RURAL PRIMARY CARE SOUTH INC

Facility Address:
143 WHITE OAK TRAIL SYUITE 2
WARRIOR, AL
ZIP 35180
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Facility Phone Number: 205 647-1777

Facility Type: Rural Health Clinic

Certificate Type: Waiver

NPI Number: 1508277310

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	01D2081262
LAB Type	Rural Health Clinic
Facility Name	RURAL PRIMARY CARE SOUTH INC
Street	143 WHITE OAK TRAIL SYUITE 2
City	WARRIOR
State	AL
ZIP	35180
Phone	205 647-1777
CertificateType	4
CertificateEffectiveDate	7/22/2022
CertificateExpirationDate	7/21/2024
FacilityType	Waiver

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