01D2109363 CLIA NUMBER - PREMISE HEALTH OF ALABAMA MEDICAL, PC

Laboratory Demographics

  • CLIA Code: 01D2109363
  • Facility Name: PREMISE HEALTH OF ALABAMA MEDICAL, PC
  • Facility Address: 971 FAIRFAX PARK SUITE B
    TUSCALOOSA, AL
    ZIP 35406
  • Facility Phone: 659 244-2047
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. ANTHONY DRAKE
  • NPI Number: 1508416314
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 01D2109363
LAB Type Physician Office
Facility Name PREMISE HEALTH OF ALABAMA MEDICAL, PC
Street 971 FAIRFAX PARK SUITE B
City TUSCALOOSA
State AL
ZIP 35406
Phone 659 244-2047
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/24/2024
Certificate Expiration Date 2/23/2026
Facility Type Physician Office
Lab Director DR. ANTHONY DRAKE

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