01D1002498 CLIA NUMBER - HEADLAND FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 01D1002498
  • Facility Name: HEADLAND FAMILY MEDICINE
  • Facility Address: 204 HOLMAN DRIVE
    HEADLAND, AL
    ZIP 36345
  • Facility Phone: 334 693-3336
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NIEL RASMUSSEN
  • NPI Number: 1730126129
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 01D1002498
LAB Type Physician Office
Facility Name HEADLAND FAMILY MEDICINE
Street 204 HOLMAN DRIVE
City HEADLAND
State AL
ZIP 36345
Phone 334 693-3336
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/28/2025
Certificate Expiration Date 7/27/2027
Facility Type Physician Office
Lab Director NIEL RASMUSSEN

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