01D2200373 CLIA NUMBER - SOUTHERN WELLNESS, LLC

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Laboratory Demographics

CLIA Number: 01D2200373

Facility Name: SOUTHERN WELLNESS, LLC

Facility Address:
321 1ST ST NORTH
ALABASTER, AL
ZIP 35007
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Facility Phone Number: 205 624-4325

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1437527009

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	01D2200373
LAB Type	Physician Office
Facility Name	SOUTHERN WELLNESS, LLC
Street	321 1ST ST NORTH
City	ALABASTER
State	AL
ZIP	35007
Phone	205 624-4325
CertificateType	4
CertificateEffectiveDate	11/16/2022
CertificateExpirationDate	11/15/2024
FacilityType	Waiver

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