01D2168970 CLIA NUMBER - REGIONAL MEDICAL CENTER CLINIC

Laboratory Demographics

CLIA Number: 01D2168970

Facility Name: REGIONAL MEDICAL CENTER CLINIC

Facility Address:
125 CHURCH STREET
GEORGIANA, AL
ZIP 36033
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Facility Phone Number: 334 376-2291

Facility Type: Rural Health Clinic

Certificate Type: Waiver

NPI Number: 1245372168

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	01D2168970
LAB Type	Rural Health Clinic
Facility Name	REGIONAL MEDICAL CENTER CLINIC
Street	125 CHURCH STREET
City	GEORGIANA
State	AL
ZIP	36033
Phone	334 376-2291
CertificateType	4
CertificateEffectiveDate	10/25/2023
CertificateExpirationDate	10/24/2025
FacilityType	Waiver

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