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01D2287892 CLIA NUMBER - IVY CREEK MEDICAL ASSOCIATES

Laboratory Demographics

CLIA Number: 01D2287892

Facility Name: IVY CREEK MEDICAL ASSOCIATES

Facility Address:
73996 TALLASSEE HIGHWAY
WETUMPKA, AL
ZIP 36092
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Facility Phone Number: 334 567-4116

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1154642684

Taxonomy: 208600000X - Surgery
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

CLIA Record

Field Name Field Value
CLIA Number 01D2287892
LAB Type Physician Office
Facility Name IVY CREEK MEDICAL ASSOCIATES
Street 73996 TALLASSEE HIGHWAY
City WETUMPKA
State AL
ZIP 36092
Phone 334 567-4116
CertificateType 4
CertificateEffectiveDate 8/18/2023
CertificateExpirationDate 8/17/2025
FacilityType Waiver

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