01D2267067 CLIA NUMBER - OLYMPUS DIRECT PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 01D2267067
  • Facility Name: OLYMPUS DIRECT PRIMARY CARE
  • Facility Address: 1311 DECATUR HWY, SUITE C
    FULTONDALE, AL
    ZIP 35068
  • Facility Phone: 205 927-5185
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JUSTIN T. COOKE
  • NPI Number: 1619696598
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 01D2267067
LAB Type Physician Office
Facility Name OLYMPUS DIRECT PRIMARY CARE
Street 1311 DECATUR HWY, SUITE C
City FULTONDALE
State AL
ZIP 35068
Phone 205 927-5185
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/19/2024
Certificate Expiration Date 8/18/2026
Facility Type Physician Office
Lab Director JUSTIN T. COOKE

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