01D2193183 CLIA NUMBER - AUBURN PERIODONTICS

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Laboratory Demographics

CLIA Number: 01D2193183

Facility Name: AUBURN PERIODONTICS

Facility Address:
670 N COLLEGE STREET, SUITE D
AUBURN, AL
ZIP 36830
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Facility Phone Number: 334 209-1352

Facility Type: Other - DENTAL CLINIC

Certificate Type: Waiver

NPI Number: 1427429661

Taxonomy: 1223P0300X - Dentist
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

CLIA Record

Field Name	Field Value
CLIA Number	01D2193183
LAB Type	Other - DENTAL CLINIC
Facility Name	AUBURN PERIODONTICS
Street	670 N COLLEGE STREET, SUITE D
City	AUBURN
State	AL
ZIP	36830
Phone	334 209-1352
CertificateType	4
CertificateEffectiveDate	9/17/2022
CertificateExpirationDate	9/16/2024
FacilityType	Waiver

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