01D2276103 CLIA NUMBER - SOUTHERN LUX HEALTH AND METABOLIC WELLNESS

Laboratory Demographics

  • CLIA Code: 01D2276103
  • Facility Name: SOUTHERN LUX HEALTH AND METABOLIC WELLNESS
  • Facility Address: 3332 W MAIN ST, SUITE 2
    DOTHAN, AL
    ZIP 36305
  • Facility Phone: 334 246-2577
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KELLY E. BLAKE
  • NPI Number: 1316177488
  • Taxonomy: 207W00000X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 01D2276103
LAB Type Physician Office
Facility Name SOUTHERN LUX HEALTH AND METABOLIC WELLNESS
Street 3332 W MAIN ST, SUITE 2
City DOTHAN
State AL
ZIP 36305
Phone 334 246-2577
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/2/2025
Certificate Expiration Date 2/1/2027
Facility Type Physician Office
Lab Director KELLY E. BLAKE

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