01D1095660 CLIA NUMBER - OUTPATIENT DIAGNOSTIC CENTER

Laboratory Demographics

  • CLIA Code: 01D1095660
  • Facility Name: OUTPATIENT DIAGNOSTIC CENTER
  • Facility Address: 115 ST CLAIR AVENUE SE
    HUNTSVILLE, AL
    ZIP 35801
  • Facility Phone: 256 534-5600
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: CHUCK MILES
  • NPI Number: 1811945306
  • Taxonomy: 293D00000X - Physiological Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 01D1095660
LAB Type Independent
Facility Name OUTPATIENT DIAGNOSTIC CENTER
Street 115 ST CLAIR AVENUE SE
City HUNTSVILLE
State AL
ZIP 35801
Phone 256 534-5600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/12/2025
Certificate Expiration Date 2/11/2027
Facility Type Independent
Lab Director CHUCK MILES

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This page was last updated on: 6/4/2025