01D0995925 CLIA NUMBER - ANNISTON GERIATRIC

Laboratory Demographics

  • CLIA Code: 01D0995925
  • Facility Name: ANNISTON GERIATRIC
  • Facility Address: 1112 CHRISTINE AVENUE
    ANNISTON, AL
    ZIP 36207
  • Facility Phone: 256 237-2351
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: IGOR BIDIKOV
  • NPI Number: 1457429516
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 01D0995925
LAB Type Physician Office
Facility Name ANNISTON GERIATRIC
Street 1112 CHRISTINE AVENUE
City ANNISTON
State AL
ZIP 36207
Phone 256 237-2351
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/5/2024
Certificate Expiration Date 2/4/2026
Facility Type Physician Office
Lab Director IGOR BIDIKOV

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