01D2124986 CLIA NUMBER - VASCULAR CENTER OF MOBILE PC

Laboratory Demographics

CLIA Number: 01D2124986

Facility Name: VASCULAR CENTER OF MOBILE PC

Facility Address:
1151 DAUPHIN STREET
MOBILE, AL
ZIP 36604
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Facility Phone Number: 251 445-0075

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1295013696

Taxonomy: 2086S0129X - Surgery
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

CLIA Record

Field Name	Field Value
CLIA Number	01D2124986
LAB Type	Physician Office
Facility Name	VASCULAR CENTER OF MOBILE PC
Street	1151 DAUPHIN STREET
City	MOBILE
State	AL
ZIP	36604
Phone	251 445-0075
CertificateType	4
CertificateEffectiveDate	1/30/2023
CertificateExpirationDate	1/29/2025
FacilityType	Waiver

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