CLIA lab
CLIA 01D0965487: Rizk M Moutagaly/Gandy Street Clinic
Russellville, AL. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 01D0965487 belongs to Rizk M Moutagaly/Gandy Street Clinic in Russellville, AL.
Certificate of Waiver, effective September 22, 2025, expires September 21, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- September 22, 2025
- Certificate expiration
- September 21, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- September 22, 1999
- Facility type
- Community clinic
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 01D0965487
- Lab name
- Rizk M Moutagaly/Gandy Street Clinic
- Address
- 715 Gandy Street NE Suite C, Russellville, AL 35653
- Phone
- (256) 332-1175
- Fax
- (256) 332-1171
Annual test volume the lab reported
- Waived tests
- 260
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Bowling Family Medical ClinicCertificate of Waiver, Rural health clinic01D2170100
- Country CottageCertificate of Waiver, Assisted living facility01D2193936
- Family Health Care Clinic Inc - RussellvilleCertificate for Provider-Performed Microscopy Procedures, Federally qualified health center01D2002346
- Family Pharmacy of RussellvilleCertificate of Waiver, Pharmacy01D2225417
- Franklin County JailCertificate of Waiver, Other01D1069290
- Harry W Kuberg MDCertificate for Provider-Performed Microscopy Procedures, Physician office01D0981272
- Health Connect America, IncCertificate of Waiver, Other01D2148294
- Kevin G Kelly MDCertificate of Compliance, Physician office01D0871507
- Lloyd C Dyas MD PCCertificate of Waiver, Physician office01D2068842
Related
Questions
What is the CLIA number for Rizk M Moutagaly/Gandy Street Clinic in Russellville?
01D0965487, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Rizk M Moutagaly/Gandy Street Clinic hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 01D0965487 expire?
The CMS file lists September 21, 2027 as the certificate expiration date; the certificate took effect September 22, 2025.