01D0672718 CLIA NUMBER - EAST GLEN LLC

Laboratory Demographics

  • CLIA Code: 01D0672718
  • Facility Name: EAST GLEN LLC
  • Facility Address: 53 MEDICAL PARK DRIVE EAST
    BIRMINGHAM, AL
    ZIP 35235
  • Facility Phone: 205 836-4231
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JON HANNAH
  • NPI Number: 1366498941
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 01D0672718
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name EAST GLEN LLC
Street 53 MEDICAL PARK DRIVE EAST
City BIRMINGHAM
State AL
ZIP 35235
Phone 205 836-4231
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 Skilled Nursing Facility/Nursing Facility
Lab Director JON HANNAH

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