01D2300531 CLIA NUMBER - SHA DIABETES CENTER

Laboratory Demographics

  • CLIA Code: 01D2300531
  • Facility Name: SHA DIABETES CENTER
  • Facility Address: 172 LUDS WAY
    DOTHAN, AL
    ZIP 36303
  • Facility Phone: 334 475-0646
  • Facility Type: Other - DIABETES CENTER
  • Facility Type: Waiver
  • Lab Director: TAI H. BOLAJI
  • NPI Number: 1063293603
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 01D2300531
LAB Type Other - DIABETES CENTER
Facility Name SHA DIABETES CENTER
Street 172 LUDS WAY
City DOTHAN
State AL
ZIP 36303
Phone 334 475-0646
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/12/2024
Certificate Expiration Date 3/11/2026
Facility Type Other - DIABETES CENTER
Lab Director TAI H. BOLAJI

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