11D0257166 CLIA NUMBER - PRUITTHEALTH - COVINGTON, LLC

Laboratory Demographics

  • CLIA Code: 11D0257166
  • Facility Name: PRUITTHEALTH - COVINGTON, LLC
  • Facility Address: 4148 CARROLL STREET
    COVINGTON, GA
    ZIP 30014
  • Facility Phone: 770 786-0427
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: LORIE SCROGGS
  • NPI Number: 1457797177
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 11D0257166
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PRUITTHEALTH - COVINGTON, LLC
Street 4148 CARROLL STREET
City COVINGTON
State GA
ZIP 30014
Phone 770 786-0427
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director LORIE SCROGGS

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