01D0303750 CLIA NUMBER - DEKALB PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 01D0303750
  • Facility Name: DEKALB PRIMARY CARE
  • Facility Address: 83 GEORGE WALLACE DRIVE
    RAINSVILLE, AL
    ZIP 35986
  • Facility Phone: 256 801-6048
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. RICKY G. DEERMAN
  • NPI Number: 1528821402
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 01D0303750
LAB Type Physician Office
Facility Name DEKALB PRIMARY CARE
Street 83 GEORGE WALLACE DRIVE
City RAINSVILLE
State AL
ZIP 35986
Phone 256 801-6048
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director DR. RICKY G. DEERMAN

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This page was last updated on: 6/4/2025