01D2104062 CLIA NUMBER - REMNANT MEDICINE LLC

Laboratory Demographics

  • CLIA Code: 01D2104062
  • Facility Name: REMNANT MEDICINE LLC
  • Facility Address: 1805 STATION DRIVE
    PRATTVILLE, AL
    ZIP 36066
  • Facility Phone: 334 730-0880
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AMANDA D. WILCOX MD
  • NPI Number: 1164891248
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 01D2104062
LAB Type Physician Office
Facility Name REMNANT MEDICINE LLC
Street 1805 STATION DRIVE
City PRATTVILLE
State AL
ZIP 36066
Phone 334 730-0880
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/27/2023
Certificate Expiration Date 10/26/2025
Facility Type Physician Office
Lab Director AMANDA D. WILCOX MD

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