01D0882247 CLIA NUMBER - LAFAYETTE EXTENDED CARE

Laboratory Demographics

  • CLIA Code: 01D0882247
  • Facility Name: LAFAYETTE EXTENDED CARE
  • Facility Address: 805 HOSPITAL STREET
    LAFAYETTE, AL
    ZIP 36862
  • Facility Phone: 334 864-8854
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: BONITA CALLOWAY
  • NPI Number: 1205878097
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 01D0882247
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name LAFAYETTE EXTENDED CARE
Street 805 HOSPITAL STREET
City LAFAYETTE
State AL
ZIP 36862
Phone 334 864-8854
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/31/2024
Certificate Expiration Date 1/30/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director BONITA CALLOWAY

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