01D2263202 CLIA NUMBER - MEDPRO MOBILE LLC

Laboratory Demographics

  • CLIA Code: 01D2263202
  • Facility Name: MEDPRO MOBILE LLC
  • Facility Address: 201 ELIZABETH ST B2S6
    BOAZ, AL
    ZIP 35957
  • Facility Phone: 256 506-7289
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: MS. ASHLEY C. SMITH
  • NPI Number: 1588346142
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 01D2263202
LAB Type Mobile Laboratory
Facility Name MEDPRO MOBILE LLC
Street 201 ELIZABETH ST B2S6
City BOAZ
State AL
ZIP 35957
Phone 256 506-7289
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/24/2024
Certificate Expiration Date 6/23/2026
Facility Type Mobile Laboratory
Lab Director MS. ASHLEY C. SMITH

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