11D0264467 CLIA NUMBER - SOUTHSIDE OB/GYN

Laboratory Demographics

CLIA Number: 11D0264467

Facility Name: SOUTHSIDE OB/GYN

Facility Address:
10025 FORD AVE SUITE 3A
RICHMOND HILL, GA
ZIP 31324
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Facility Phone Number: 912 232-3571

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1407024557

Taxonomy: 207V00000X - Obstetrics & Gynecology
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

CLIA Record

Field Name	Field Value
CLIA Number	11D0264467
LAB Type	Physician Office
Facility Name	SOUTHSIDE OB/GYN
Street	10025 FORD AVE SUITE 3A
City	RICHMOND HILL
State	GA
ZIP	31324
Phone	912 232-3571
CertificateType	3
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	PPMP

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This page was last updated on: 4/23/2024