01D0704439 CLIA NUMBER - FCI TALLADEGA

Laboratory Demographics

  • CLIA Code: 01D0704439
  • Facility Name: FCI TALLADEGA
  • Facility Address: ATTN HEALTH SERVICES 565 EAST RENFROE RD
    TALLADEGA, AL
    ZIP 35160
  • Facility Phone: 256 315-4124
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: DR. W MARK HOLBROOK MD CD
  • NPI Number: 1033719729
  • Taxonomy: 261QP2400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 01D0704439
LAB Type Other
Facility Name FCI TALLADEGA
Street ATTN HEALTH SERVICES 565 EAST RENFROE RD
City TALLADEGA
State AL
ZIP 35160
Phone 256 315-4124
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/15/2025
Certificate Expiration Date 8/14/2027
Facility Type Other
Lab Director DR. W MARK HOLBROOK MD CD

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This page was last updated on: 9/29/2025