01D0953207 CLIA NUMBER - DIALYSIS CLINIC INC - MOULTON

Laboratory Demographics

  • CLIA Code: 01D0953207
  • Facility Name: DIALYSIS CLINIC INC - MOULTON
  • Facility Address: 1962 MAIN ST
    MOULTON, AL
    ZIP 35650
  • Facility Phone: 256 974-1400
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: REGINALD GLADISH
  • NPI Number: 1760415145
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 01D0953207
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name DIALYSIS CLINIC INC - MOULTON
Street 1962 MAIN ST
City MOULTON
State AL
ZIP 35650
Phone 256 974-1400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2024
Certificate Expiration Date 10/27/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director REGINALD GLADISH

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