11D0260977 CLIA NUMBER - GENE S KENNEDY MD PC

Laboratory Demographics

  • CLIA Code: 11D0260977
  • Facility Name: GENE S KENNEDY MD PC
  • Facility Address: 2483 DEMERE ROAD SUITE 206
    SAINT SIMONS ISLAND, GA
    ZIP 31522
  • Facility Phone: 912 634-2651
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: GENE S. KENNEDY
  • NPI Number: 1255438214
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0260977
LAB Type Physician Office
Facility Name GENE S KENNEDY MD PC
Street 2483 DEMERE ROAD SUITE 206
City SAINT SIMONS ISLAND
State GA
ZIP 31522
Phone 912 634-2651
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 2/29/2024
Certificate Expiration Date 2/27/2026
Facility Type Physician Office
Lab Director GENE S. KENNEDY

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