11D0262105 CLIA NUMBER - MIGUEL E COSSIO MD

Laboratory Demographics

  • CLIA Code: 11D0262105
  • Facility Name: MIGUEL E COSSIO MD
  • Facility Address: 1075 SOUTH MAIN ST SUITE 400
    MADISON, GA
    ZIP 30650
  • Facility Phone: 706 342-9664
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MIGUEL E. COSSIO MD
  • NPI Number: 1669426557
  • Taxonomy: 207R00000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D0262105
LAB Type Physician Office
Facility Name MIGUEL E COSSIO MD
Street 1075 SOUTH MAIN ST SUITE 400
City MADISON
State GA
ZIP 30650
Phone 706 342-9664
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/3/2024
Certificate Expiration Date 5/2/2026
Facility Type Physician Office
Lab Director MIGUEL E. COSSIO MD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 3/20/2025