01D2302684 CLIA NUMBER - LAKE MARTIN HOSPICE, LLC D/B/A IVY CREEK HOSPICE

Laboratory Demographics

  • CLIA Code: 01D2302684
  • Facility Name: LAKE MARTIN HOSPICE, LLC D/B/A IVY CREEK HOSPICE
  • Facility Address: 201 MARIARDEN ROAD
    DADEVILLE, AL
    ZIP 36853
  • Facility Phone: 256 825-3272
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: LINDA S. SEGREST
  • NPI Number: 1346305216
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 01D2302684
LAB Type Hospice
Facility Name LAKE MARTIN HOSPICE, LLC D/B/A IVY CREEK HOSPICE
Street 201 MARIARDEN ROAD
City DADEVILLE
State AL
ZIP 36853
Phone 256 825-3272
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/15/2024
Certificate Expiration Date 4/14/2026
Facility Type Hospice
Lab Director LINDA S. SEGREST

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