11D0265053 CLIA NUMBER - WAYCROSS INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 11D0265053
  • Facility Name: WAYCROSS INTERNAL MEDICINE
  • Facility Address: 711 KNIGHT AVENUE
    WAYCROSS, GA
    ZIP 31501
  • Facility Phone: 912 283-9423
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: JILL G. BRYANT
  • NPI Number: 1144420530
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0265053
LAB Type Physician Office
Facility Name WAYCROSS INTERNAL MEDICINE
Street 711 KNIGHT AVENUE
City WAYCROSS
State GA
ZIP 31501
Phone 912 283-9423
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 12/4/2023
Certificate Expiration Date 12/3/2025
Facility Type Physician Office
Lab Director JILL G. BRYANT

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