01D2072485 CLIA NUMBER - MODEL CITY HOME TRAINING

Laboratory Demographics

  • CLIA Code: 01D2072485
  • Facility Name: MODEL CITY HOME TRAINING
  • Facility Address: 1724 LEIGHTON AVE
    ANNISTON, AL
    ZIP 36207
  • Facility Phone: 256 236-5864
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: JEFFREY GLAZE MD
  • NPI Number: 1669801643
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 01D2072485
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name MODEL CITY HOME TRAINING
Street 1724 LEIGHTON AVE
City ANNISTON
State AL
ZIP 36207
Phone 256 236-5864
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/31/2024
Certificate Expiration Date 1/30/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director JEFFREY GLAZE MD

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