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01D2273514 CLIA NUMBER - EQUAL JUSTICE INITIATIVE

Laboratory Demographics

CLIA Number: 01D2273514

Facility Name: EQUAL JUSTICE INITIATIVE

Facility Address:
421 ST LUKE'S DRIVE
MONTGOMERY, AL
ZIP 36117
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Facility Phone Number: 334 269-1803

Facility Type: Other - FREE CLINIC

Certificate Type: Waiver
NPI Number: 1366146904

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name Field Value
CLIA Number 01D2273514
LAB Type Other - FREE CLINIC
Facility Name EQUAL JUSTICE INITIATIVE
Street 421 ST LUKE'S DRIVE
City MONTGOMERY
State AL
ZIP 36117
Phone 334 269-1803
CertificateType 4
CertificateEffectiveDate 12/14/2022
CertificateExpirationDate 12/13/2024
FacilityType Waiver

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