01D2129988 CLIA NUMBER - MISSION MEDICAL INC

Laboratory Demographics

  • CLIA Code: 01D2129988
  • Facility Name: MISSION MEDICAL INC
  • Facility Address: 124 JACKSON AVENUE SOUTH, SUITE C
    RUSSELLVILLE, AL
    ZIP 35653
  • Facility Phone: 256 857-1223
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NINA J. STOWE FNP
  • NPI Number: 1982136123
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 01D2129988
LAB Type Physician Office
Facility Name MISSION MEDICAL INC
Street 124 JACKSON AVENUE SOUTH, SUITE C
City RUSSELLVILLE
State AL
ZIP 35653
Phone 256 857-1223
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/28/2025
Certificate Expiration Date 4/27/2027
Facility Type Physician Office
Lab Director NINA J. STOWE FNP

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