01D2170571 CLIA NUMBER - WILSON DAM CLINIC

Laboratory Demographics

  • CLIA Code: 01D2170571
  • Facility Name: WILSON DAM CLINIC
  • Facility Address: 4951 WILSON DAM ROAD
    TUSCUMBIA, AL
    ZIP 35674
  • Facility Phone: 256 320-5636
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: JEREMY P. TAYLOR
  • NPI Number: 1457843708
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 01D2170571
LAB Type Community Clinic
Facility Name WILSON DAM CLINIC
Street 4951 WILSON DAM ROAD
City TUSCUMBIA
State AL
ZIP 35674
Phone 256 320-5636
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/14/2025
Certificate Expiration Date 8/13/2027
Facility Type Community Clinic
Lab Director JEREMY P. TAYLOR

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