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01D2097649 CLIA NUMBER - ST VINCENT'S PRIMARY CARE GARDENDALE

Laboratory Demographics

CLIA Number: 01D2097649

Facility Name: ST VINCENT'S PRIMARY CARE GARDENDALE

Facility Address:
2217 DECATUR HWY SUITE 101
GARDENDALE, AL
ZIP 35071
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Facility Phone Number: 205 418-1200

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1992051379

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name Field Value
CLIA Number 01D2097649
LAB Type Physician Office
Facility Name ST VINCENT'S PRIMARY CARE GARDENDALE
Street 2217 DECATUR HWY SUITE 101
City GARDENDALE
State AL
ZIP 35071
Phone 205 418-1200
CertificateType 4
CertificateEffectiveDate 6/19/2023
CertificateExpirationDate 6/18/2025
FacilityType Waiver

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