01D0673552 CLIA NUMBER - DIVERSICARE OF PELL CITY

Laboratory Demographics

  • CLIA Code: 01D0673552
  • Facility Name: DIVERSICARE OF PELL CITY
  • Facility Address: 510 WOLF CREEK RD NORTH
    PELL CITY, AL
    ZIP 35125
  • Facility Phone: 205 338-3329
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: SAM COOK
  • NPI Number: 1942755038
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 01D0673552
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name DIVERSICARE OF PELL CITY
Street 510 WOLF CREEK RD NORTH
City PELL CITY
State AL
ZIP 35125
Phone 205 338-3329
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 SAM COOK

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