COMMUNITY HOSPITAL CLINICAL LAB (NPI# 1568590339) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568590339 |
| Entity Type | Organization |
| Organization Name | COMMUNITY HOSPITAL CLINICAL LAB |
| Practice Address |
875 Friendship Rd Tallassee AL 36078-1234 |
| Mailing Address |
805 Friendship Rd Tallassee AL 36078-1234 |
| Practice Telephone | 3342833734 |
| Mailing Telephone | 3342836541 |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. LEE S GREER (CFO) |
| Authorized Official Telephone | 3342833734 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | H2602 | AL | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | BCBS PROVIDER NUMBER | 510-05394 | 01 |
| Street Address |
875 FRIENDSHIP RD |
| City | TALLASSEE |
| State | AL |
| Zip Code | 36078-1234 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306848494 | Thomas Daniel Holt | Family Medicine | 875 Friendship Rd, Tallassee, AL 36078-1234 | 2005-08-10 |
| 1316554181 | Adrienne Bolan | Nurse Practitioner | 875 Friendship Rd, Tallassee, AL 36078-1255 | 2020-09-25 |
| 1578072757 | Lori Michelle Woodley | Nurse Practitioner | 875 Friendship Rd, Tallassee, AL 36078-1255 | 2017-09-20 |
| 1144758756 | Brandi Criswell | Nurse Practitioner | 875 Friendship Rd, Tallassee, AL 36078-1255 | 2017-05-25 |
| 1073067856 | Deray Junior Williams | Nurse Practitioner | 875 Friendship Rd, Tallassee, AL 36078 | 2016-08-09 |
| 1952799371 | Diana L Kenyon | Nurse Practitioner | 875 Friendship Rd, Tallassee, AL 36078-1234 | 2015-01-07 |
| 1982941381 | Community Hospital Inc | Family Medicine | 875 Friendship Rd, Tallassee, AL 36078-1234 | 2013-01-07 |
| 1841468238 | Central Alabama Foot Care LLC | Durable Medical Equipment & Medical Supplies | 875 Friendship Rd, Suite J, Tallassee, AL 36078-1234 | 2008-02-19 |
| 1114118064 | Community Medical Arts Center | Family Medicine | 875 Friendship Rd, Tallassee, AL 36078-1234 | 2007-08-06 |
| 1841219078 | Chanda Day Houts | Podiatrist | 875 Friendship Rd, Suite K, Tallassee, AL 36078-1234 | 2006-07-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811286321 | Kenneth Wesley Atkins | Behavioral Analyst | 101 S Dubois, Tallassee, AL 36078 | 2011-04-05 |
| 1811089030 | Shawn Keahey | Dentist | 1608b Gilmer Avenue, Tallassee, AL 36078 | 2006-09-28 |
| 1952409088 | Randal David Herring | Chiropractor | 315 Friendship Road, Tallassee, AL 36078 | 2006-09-20 |
| 1609801133 | Alexander Robbins | Surgery | 875 Friendship Road, Cmac Suite F, Tallassee, AL 36078 | 2006-07-12 |
| 1063467447 | John H Rand | Otolaryngology | 80 Herren Hill Road, Ste D, Tallassee, AL 36078 | 2006-05-23 |
| 1881752996 | Charles D Mccartha | Dentist | 1608b Gilmer Avenue, Tallassee, AL 36078 | 2006-12-04 |
| 1013009315 | Tallassee Family Dentistry PCc | Dentist | 1608b Gilmer Avenue, Tallassee, AL 36078 | 2006-09-28 |
| 1538191648 | Tom Crain | Physical Therapist | 1000 Friendship Rd, Tallassee, AL 36078 | 2006-07-07 |
| 1417412081 | Collin Jones | Specialist/Technologist | 213 Godwin Rd, Tallassee, AL 36078-1129 | 2019-02-07 |
| 1598868234 | Alabama Cvs Pharmacy, L.L.C. | Pharmacy | 10 Gilmer Ave, Tallassee, AL 36078-1206 | 2006-09-07 |
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| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
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|---|---|---|---|---|
| 1952908626 | Matrix Labs | Clinical Medical Laboratory | 4100 Mcclellan Blvd Ste 102, Anniston, AL 36201-2132 | 2020-10-06 |
| 1619574621 | Prestige Laboratory Services | Clinical Medical Laboratory | 857 Downtowner Blvd Ste H, Mobile, AL 36609-5420 | 2020-10-02 |
| 1740897123 | Labs Plus, LLC | Clinical Medical Laboratory | 2701 Mall Dr Ste 7204, Florence, AL 35630-7502 | 2020-09-29 |
| 1841800232 | Amh Staffing Agency | Clinical Medical Laboratory | 9925 County Road 63, Plantersville, AL 36758-2853 | 2020-07-31 |
| 1861012361 | Quest Diagnostics Clinical Laboratories Inc | Clinical Medical Laboratory | 129 Mitylene Park Lane, Montgomery, AL 36117-3758 | 2020-04-24 |
| 1407487465 | Golden Point Solutions LLC | Clinical Medical Laboratory | 411a Lorna Sq, Vestavia Hills, AL 35216-5418 | 2020-01-29 |
| 1386284156 | Magnolia Diagnostic Laboratories, LLC | Clinical Medical Laboratory | 2868 Acton Rd Ste 205, Vestavia, AL 35243-2502 | 2020-01-09 |
| 1780220863 | Sharon Masters | Clinical Medical Laboratory | 1930 Edwards Lake Rd Ste 138, Birmingham, AL 35235-3720 | 2019-11-23 |
| 1518518968 | Daniel Loper | Clinical Medical Laboratory | 3750 Moffett Rd, Mobile, AL 36618-1208 | 2019-09-26 |
| 1124676796 | Quest Diagnostics Clinical Laboratories Inc | Clinical Medical Laboratory | 1845 Cherry St Fl 2, Montgomery, AL 36107-2613 | 2019-08-27 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.