01D2168162 CLIA NUMBER - NORTH DEKALB PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 01D2168162
  • Facility Name: NORTH DEKALB PRIMARY CARE
  • Facility Address: 136 COMMERCE AVE
    VALLEY HEAD, AL
    ZIP 35989
  • Facility Phone: 256 674-1052
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: DR. CHARLES R. BRADFORD
  • NPI Number: 1851898449
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 01D2168162
LAB Type Independent
Facility Name NORTH DEKALB PRIMARY CARE
Street 136 COMMERCE AVE
City VALLEY HEAD
State AL
ZIP 35989
Phone 256 674-1052
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/30/2025
Certificate Expiration Date 3/29/2027
Facility Type Independent
Lab Director DR. CHARLES R. BRADFORD

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