11D0264059 CLIA NUMBER - MACON MEDICAL GROUP PC

Laboratory Demographics

  • CLIA Code: 11D0264059
  • Facility Name: MACON MEDICAL GROUP PC
  • Facility Address: 640 MARTIN LUTHER KING JUNIOR BOULEVARD SUITE 200
    MACON, GA
    ZIP 31201
  • Facility Phone: 478 745-5455
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: DR. ANTHONY LUYAI
  • NPI Number: 1912914847
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0264059
LAB Type Physician Office
Facility Name MACON MEDICAL GROUP PC
Street 640 MARTIN LUTHER KING JUNIOR BOULEVARD SUITE 200
City MACON
State GA
ZIP 31201
Phone 478 745-5455
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 5/19/2024
Certificate Expiration Date 5/18/2026
Facility Type Physician Office
Lab Director DR. ANTHONY LUYAI

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