01D1103905 CLIA NUMBER - CENTERS FOR THE DEVELOPMENTALLY DISABLED NORTH CENTRAL AL INC

Laboratory Demographics

  • CLIA Code: 01D1103905
  • Facility Name: CENTERS FOR THE DEVELOPMENTALLY DISABLED NORTH CENTRAL AL INC
  • Facility Address: 1602 CHURCH STREET
    DECATUR, AL
    ZIP 35602
  • Facility Phone: 256 350-1458
  • Facility Type: Intermediate Care Facility for Mentally Retarded
  • Facility Type: Waiver
  • Lab Director: MAURICE B. ROMINE
  • NPI Number: 1740493436
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 01D1103905
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name CENTERS FOR THE DEVELOPMENTALLY DISABLED NORTH CENTRAL AL INC
Street 1602 CHURCH STREET
City DECATUR
State AL
ZIP 35602
Phone 256 350-1458
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/20/2025
Certificate Expiration Date 8/19/2027
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director MAURICE B. ROMINE

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