01D2119386 CLIA NUMBER - TIDE LABORATORIES LLC

Laboratory Demographics

  • CLIA Code: 01D2119386
  • Facility Name: TIDE LABORATORIES LLC
  • Facility Address: 913 AIRPORT ROAD
    FORT PAYNE, AL
    ZIP 35968
  • Facility Phone: 256 845-1261
  • Facility Type: Independent
  • Facility Type: Accreditation
  • Lab Director: ELIZABETH RAYBURN
  • NPI Number: 1306343231
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 01D2119386
LAB Type Independent
Facility Name TIDE LABORATORIES LLC
Street 913 AIRPORT ROAD
City FORT PAYNE
State AL
ZIP 35968
Phone 256 845-1261
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 6/21/2025
Certificate Expiration Date 6/20/2027
Facility Type Independent
Lab Director ELIZABETH RAYBURN

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