01D2258362 CLIA NUMBER - HARTSELLE FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 01D2258362
  • Facility Name: HARTSELLE FAMILY PRACTICE
  • Facility Address: 301 PINE STREET NW, STE C
    HARTSELLE, AL
    ZIP 35640
  • Facility Phone: 256 973-5730
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. AMIT VORA
  • NPI Number: 1710936547
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 01D2258362
LAB Type Physician Office
Facility Name HARTSELLE FAMILY PRACTICE
Street 301 PINE STREET NW, STE C
City HARTSELLE
State AL
ZIP 35640
Phone 256 973-5730
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/20/2024
Certificate Expiration Date 4/19/2026
Facility Type Physician Office
Lab Director DR. AMIT VORA

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