Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ansenio Clark, MLT

Individual provider Clinical Medical Laboratory · NPI 1699517821

Ansenio Clark, MLT is a Clinical Medical Laboratory in Montgomery, Alabama. Practices as a sole proprietor. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

1565 E Trinity Blvd
Montgomery, AL 36106-2897
Phone: (334) 440-4538
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Medical Laboratory (primary) Taxonomy 291U00000X

Record details

NPI number1699517821
Entity typeIndividual (Type 1)
GenderMale
Credentials MLT
Sole proprietorYes
NPI enumeratedJune 10, 2024
Last updated in NPPESJune 10, 2024
Certification dateJune 10, 2024
Mailing address1565 E Trinity Blvd, Montgomery, AL 36106-2897

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