01D2285582 CLIA NUMBER - GADSDEN FAMILY PRACTICE

Laboratory Demographics

CLIA Number: 01D2285582

Facility Name: GADSDEN FAMILY PRACTICE

Facility Address:
851 GOODYEAR AVENUE
GADSDEN, AL
ZIP 35903
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Facility Phone Number: 256 413-6016

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1184673535

Taxonomy: 261QC1500X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	01D2285582
LAB Type	Physician Office
Facility Name	GADSDEN FAMILY PRACTICE
Street	851 GOODYEAR AVENUE
City	GADSDEN
State	AL
ZIP	35903
Phone	256 413-6016
CertificateType	4
CertificateEffectiveDate	7/14/2023
CertificateExpirationDate	7/13/2025
FacilityType	Waiver

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