44D0310889 CLIA NUMBER - ALY BASSAL MD

Laboratory Demographics

CLIA Number: 44D0310889

Facility Name: ALY BASSAL MD

Facility Address:
1000 WEST G STREET SUITE 104
ELIZABETHTON, TN
ZIP 37643
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Facility Phone Number: 423 543-4616

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1275530560

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	44D0310889
LAB Type	Physician Office
Facility Name	ALY BASSAL MD
Street	1000 WEST G STREET SUITE 104
City	ELIZABETHTON
State	TN
ZIP	37643
Phone	423 543-4616
CertificateType	4
CertificateEffectiveDate	7/13/2022
CertificateExpirationDate	7/12/2024
FacilityType	Waiver

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