01D0986805 CLIA NUMBER - NOLAND EXTENDICARE, LLC DBA EXTENDICARE HEALTH AND REHAB

Laboratory Demographics

  • CLIA Code: 01D0986805
  • Facility Name: NOLAND EXTENDICARE, LLC DBA EXTENDICARE HEALTH AND REHAB
  • Facility Address: 950 S SAINT ANDREWS STREET
    DOTHAN, AL
    ZIP 36301
  • Facility Phone: 334 793-1177
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ANITA KAY COBB RN
  • NPI Number: 1487669115
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 01D0986805
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name NOLAND EXTENDICARE, LLC DBA EXTENDICARE HEALTH AND REHAB
Street 950 S SAINT ANDREWS STREET
City DOTHAN
State AL
ZIP 36301
Phone 334 793-1177
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/23/2025
Certificate Expiration Date 5/22/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director ANITA KAY COBB RN

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