01D2307987 CLIA NUMBER - EASTERN SHORE DEVELOPMENTAL CLINIC, LLC

Laboratory Demographics

  • CLIA Code: 01D2307987
  • Facility Name: EASTERN SHORE DEVELOPMENTAL CLINIC, LLC
  • Facility Address: 28150 N MAIN STREET, SUITE A
    DAPHNE, AL
    ZIP 36526
  • Facility Phone: 251 625-2400
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MS. JULIE B. WIGGINS
  • NPI Number: 1417004656
  • Taxonomy: 213ES0131X - Podiatrist

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CLIA Record

Field Name Field Value
CLIA Number 01D2307987
LAB Type Physician Office
Facility Name EASTERN SHORE DEVELOPMENTAL CLINIC, LLC
Street 28150 N MAIN STREET, SUITE A
City DAPHNE
State AL
ZIP 36526
Phone 251 625-2400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/18/2024
Certificate Expiration Date 7/17/2026
Facility Type Physician Office
Lab Director MS. JULIE B. WIGGINS

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