11D0261428 CLIA NUMBER - LCNGHS SPECIALTY CARE IN DEMOREST

Laboratory Demographics

  • CLIA Code: 11D0261428
  • Facility Name: LCNGHS SPECIALTY CARE IN DEMOREST
  • Facility Address: 801 AUSTIN DRIVE
    DEMOREST, GA
    ZIP 30535
  • Facility Phone: 706 680-6905
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. W RHETT WEAVER
  • NPI Number: 1760956551
  • Taxonomy: 207L00000X - Anesthesiology

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CLIA Record

Field Name Field Value
CLIA Number 11D0261428
LAB Type Physician Office
Facility Name LCNGHS SPECIALTY CARE IN DEMOREST
Street 801 AUSTIN DRIVE
City DEMOREST
State GA
ZIP 30535
Phone 706 680-6905
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/23/2023
Certificate Expiration Date 12/22/2025
Facility Type Physician Office
Lab Director DR. W RHETT WEAVER

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