OrganizationActive
Ivy Creek of Tallapoosa, LLC
NPI 1932783693 · Clinical Medical Laboratory · Dadeville, AL
Provider details
- NPI number
- 1932783693
- Entity type
- Organization
- Primary specialty
- Clinical Medical LaboratoryLaboratories
- Parent organization
- Ivy Creek of Tallapoosa, LLC
- Organization subpart
- Yes
- Authorized official
- Michael Bruce, Ceo(334) 567-4311
Specialties & taxonomies
Laboratories
Profile Score
Established profile(62/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
201 Mariarden Road
Dadeville, AL 36853
Phone: (256) 825-7821
Street-level locationGet directions
Mailing address
Po Box 130
Wetumpka, AL 36092-0003
Other names (DBA / former)
- Doing business as
- Reference Lab
Registry dates
- Enumerated
- 2021-05-10
- Last updated
- 2022-04-05
- Certified
- 2022-04-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.