01D2302272 CLIA NUMBER - REAGAN'S CLINIC

Laboratory Demographics

  • CLIA Code: 01D2302272
  • Facility Name: REAGAN'S CLINIC
  • Facility Address: 12205 COUNTY LINE ROAD, SUITE C
    MADISON, AL
    ZIP 35758
  • Facility Phone: 256 258-8319
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MARC A. HULTQUIST
  • NPI Number: 1558123190
  • Taxonomy: 2080P0006X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 01D2302272
LAB Type Physician Office
Facility Name REAGAN'S CLINIC
Street 12205 COUNTY LINE ROAD, SUITE C
City MADISON
State AL
ZIP 35758
Phone 256 258-8319
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/8/2024
Certificate Expiration Date 4/7/2026
Facility Type Physician Office
Lab Director DR. MARC A. HULTQUIST

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