11D0263359 CLIA NUMBER - HENRY W YOUNG MD

Laboratory Demographics

  • CLIA Code: 11D0263359
  • Facility Name: HENRY W YOUNG MD
  • Facility Address: 501 EAST THIRD AVE
    CORDELE, GA
    ZIP 31015
  • Facility Phone: 912 273-0841
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: HENRY W. YOUNG
  • NPI Number: 1528164373
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0263359
LAB Type Physician Office
Facility Name HENRY W YOUNG MD
Street 501 EAST THIRD AVE
City CORDELE
State GA
ZIP 31015
Phone 912 273-0841
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 9/15/2025
Certificate Expiration Date 9/14/2027
Facility Type Physician Office
Lab Director HENRY W. YOUNG

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