01D0890102 CLIA NUMBER - SELMA FAMILY PRACTICE OPTOMETRY INC

Laboratory Demographics

  • CLIA Code: 01D0890102
  • Facility Name: SELMA FAMILY PRACTICE OPTOMETRY INC
  • Facility Address: 2401 MEDICAL CENTER PARKWAY
    SELMA, AL
    ZIP 36701
  • Facility Phone: 334 872-2321
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: DR. LEROY MAXWELL
  • NPI Number: 1871677260
  • Taxonomy: 152W00000X - Optometrist

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 01D0890102
LAB Type Practitioner Other
Facility Name SELMA FAMILY PRACTICE OPTOMETRY INC
Street 2401 MEDICAL CENTER PARKWAY
City SELMA
State AL
ZIP 36701
Phone 334 872-2321
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/4/2023
Certificate Expiration Date 12/3/2025
Facility Type Practitioner Other
Lab Director DR. LEROY MAXWELL

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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