01D2266697 CLIA NUMBER - ST LUKE INTEGRATIVE MEDICAL CENTER

Laboratory Demographics

CLIA Number: 01D2266697

Facility Name: ST LUKE INTEGRATIVE MEDICAL CENTER

Facility Address:
415-E CHURCH ST SUITE 4
HUNTSVILLE, AL
ZIP 35801
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Facility Phone Number: 256 489-0757

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1184282840

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	01D2266697
LAB Type	Physician Office
Facility Name	ST LUKE INTEGRATIVE MEDICAL CENTER
Street	415-E CHURCH ST SUITE 4
City	HUNTSVILLE
State	AL
ZIP	35801
Phone	256 489-0757
CertificateType	4
CertificateEffectiveDate	8/15/2022
CertificateExpirationDate	8/14/2024
FacilityType	Waiver

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