11D0258279 CLIA NUMBER - UPSON WOMENS SERVICES

Laboratory Demographics

  • CLIA Code: 11D0258279
  • Facility Name: UPSON WOMENS SERVICES
  • Facility Address: 917 WEST GORDON STREET, SUITE A
    THOMASTON, GA
    ZIP 30286
  • Facility Phone: (706) 647-9627
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: CHRISTOPHER N. MOGA
  • NPI Number: 1881842821
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 11D0258279
LAB Type Physician Office
Facility Name UPSON WOMENS SERVICES
Street 917 WEST GORDON STREET, SUITE A
City THOMASTON
State GA
ZIP 30286
Phone 7066479627
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/18/2024
Certificate Expiration Date 9/17/2026
Facility Type Physician Office
Lab Director CHRISTOPHER N. MOGA

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This page was last updated on: 5/18/2026