11D0263663 CLIA NUMBER - PATRICE D BODDIE MD

Laboratory Demographics

  • CLIA Code: 11D0263663
  • Facility Name: PATRICE D BODDIE MD
  • Facility Address: 240 NORTH WAYNE STREET
    MILLEDGEVILLE, GA
    ZIP 31061
  • Facility Phone: (912) 452-6999
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PATRICE D. BODDIE
  • NPI Number: 1194151498
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0263663
LAB Type Physician Office
Facility Name PATRICE D BODDIE MD
Street 240 NORTH WAYNE STREET
City MILLEDGEVILLE
State GA
ZIP 31061
Phone 9124526999
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/6/2024
Certificate Expiration Date 8/5/2026
Facility Type Physician Office
Lab Director PATRICE D. BODDIE

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