01D2299143 CLIA NUMBER - JACKSON HOSPITAL FAMILY MEDICINE RESIDENCY

Laboratory Demographics

  • CLIA Code: 01D2299143
  • Facility Name: JACKSON HOSPITAL FAMILY MEDICINE RESIDENCY
  • Facility Address: 2024 CHESTNUT STREET
    MONTGOMERY, AL
    ZIP 36106
  • Facility Phone: 334 440-3061
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. THOMAS HORTON
  • NPI Number: 1275733693
  • Taxonomy: 282N00000X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 01D2299143
LAB Type Physician Office
Facility Name JACKSON HOSPITAL FAMILY MEDICINE RESIDENCY
Street 2024 CHESTNUT STREET
City MONTGOMERY
State AL
ZIP 36106
Phone 334 440-3061
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/14/2024
Certificate Expiration Date 2/13/2026
Facility Type Physician Office
Lab Director DR. THOMAS HORTON

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