01D2271240 CLIA NUMBER - SOUTHSIDE PHARMACY, INC

Laboratory Demographics

  • CLIA Code: 01D2271240
  • Facility Name: SOUTHSIDE PHARMACY, INC
  • Facility Address: 11964 ESCUE DRIVE SUITE A
    TANNER, AL
    ZIP 35671
  • Facility Phone: 256 232-6588
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. SCOTT J. GARRETT
  • NPI Number: 1548544752
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 01D2271240
LAB Type Pharmacy
Facility Name SOUTHSIDE PHARMACY, INC
Street 11964 ESCUE DRIVE SUITE A
City TANNER
State AL
ZIP 35671
Phone 256 232-6588
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/31/2024
Certificate Expiration Date 10/30/2026
Facility Type Pharmacy
Lab Director DR. SCOTT J. GARRETT

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