01D2070764 CLIA NUMBER - EVERNORTH DIRECT HEALTH, LLC MOHAWK ROANOKE

Laboratory Demographics

  • CLIA Code: 01D2070764
  • Facility Name: EVERNORTH DIRECT HEALTH, LLC MOHAWK ROANOKE
  • Facility Address: 1026 LAFAYETTE HIGHWAY
    ROANOKE, AL
    ZIP 36274
  • Facility Phone: 480 868-0646
  • Facility Type: Other - OUT PATIENT
  • Facility Type: Waiver
  • Lab Director: JOY NICHOLS
  • NPI Number: 1477983278
  • Taxonomy: 332900000X - Non-Pharmacy Dispensing Site

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 01D2070764
LAB Type Other - OUT PATIENT
Facility Name EVERNORTH DIRECT HEALTH, LLC MOHAWK ROANOKE
Street 1026 LAFAYETTE HIGHWAY
City ROANOKE
State AL
ZIP 36274
Phone 480 868-0646
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/23/2023
Certificate Expiration Date 12/22/2025
Facility Type Other - OUT PATIENT
Lab Director JOY NICHOLS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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