11D0265372 CLIA NUMBER - ROBERT A PUMPELLY IV MD PC

Laboratory Demographics

  • CLIA Code: 11D0265372
  • Facility Name: ROBERT A PUMPELLY IV MD PC
  • Facility Address: 124 MEMORIAL DR
    JESUP, GA
    ZIP 31545
  • Facility Phone: 912 427-4413
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT A. PUMPELLY IV
  • NPI Number: 1235121658
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0265372
LAB Type Physician Office
Facility Name ROBERT A PUMPELLY IV MD PC
Street 124 MEMORIAL DR
City JESUP
State GA
ZIP 31545
Phone 912 427-4413
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/19/2023
Certificate Expiration Date 11/18/2025
Facility Type Physician Office
Lab Director ROBERT A. PUMPELLY IV

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