01D2147782 CLIA NUMBER - JIM'S PHARMACY AT THE LAKE

Laboratory Demographics

  • CLIA Code: 01D2147782
  • Facility Name: JIM'S PHARMACY AT THE LAKE
  • Facility Address: 6378 HWY 49 S
    DADEVILLE, AL
    ZIP 36853
  • Facility Phone: 256 373-3449
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAMES L. CLANTON
  • NPI Number: 1881055564
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 01D2147782
LAB Type Pharmacy
Facility Name JIM'S PHARMACY AT THE LAKE
Street 6378 HWY 49 S
City DADEVILLE
State AL
ZIP 36853
Phone 256 373-3449
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/26/2024
Certificate Expiration Date 4/25/2026
Facility Type Pharmacy
Lab Director JAMES L. CLANTON

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