01D2148089 CLIA NUMBER - NEPHROLOGY VASCULAR LAB OF CENTRAL AL ASC, LLC

Laboratory Demographics

CLIA Number: 01D2148089

Facility Name: NEPHROLOGY VASCULAR LAB OF CENTRAL AL ASC, LLC

Facility Address:
1280 COLUMBIANA ROAD, SUITE 120
BIRMINGHAM, AL
ZIP 35216
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Facility Phone Number: 205 916-5201

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1659620912

Taxonomy: 261QM2500X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

CLIA Record

Field Name	Field Value
CLIA Number	01D2148089
LAB Type	Ambulatory Surgery Center
Facility Name	NEPHROLOGY VASCULAR LAB OF CENTRAL AL ASC, LLC
Street	1280 COLUMBIANA ROAD, SUITE 120
City	BIRMINGHAM
State	AL
ZIP	35216
Phone	205 916-5201
CertificateType	4
CertificateEffectiveDate	5/3/2024
CertificateExpirationDate	5/2/2026
FacilityType	Waiver

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