01D2210712 CLIA NUMBER - ADERHOLT MEDICAL, LLC

Laboratory Demographics

  • CLIA Code: 01D2210712
  • Facility Name: ADERHOLT MEDICAL, LLC
  • Facility Address: 108 SHADY LANE
    ATHENS, AL
    ZIP 35613
  • Facility Phone: 256 230-5280
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: BRANDI S. RAY
  • NPI Number: 1164023529
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 01D2210712
LAB Type Mobile Laboratory
Facility Name ADERHOLT MEDICAL, LLC
Street 108 SHADY LANE
City ATHENS
State AL
ZIP 35613
Phone 256 230-5280
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/22/2025
Certificate Expiration Date 1/21/2027
Facility Type Mobile Laboratory
Lab Director BRANDI S. RAY

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