11D0265418 CLIA NUMBER - BRANTLEY FAMILY MEDICINE CENTER

Laboratory Demographics

  • CLIA Code: 11D0265418
  • Facility Name: BRANTLEY FAMILY MEDICINE CENTER
  • Facility Address: 21300 HIGHWAY 82 SUITE C
    WAYNESVILLE, GA
    ZIP 31566
  • Facility Phone: 912 778-3556
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SINNATHURAI VASANTHAKUMAR
  • NPI Number: 1497201719
  • Taxonomy: 1041C0700X - Social Worker

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CLIA Record

Field Name Field Value
CLIA Number 11D0265418
LAB Type Physician Office
Facility Name BRANTLEY FAMILY MEDICINE CENTER
Street 21300 HIGHWAY 82 SUITE C
City WAYNESVILLE
State GA
ZIP 31566
Phone 912 778-3556
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/13/2024
Certificate Expiration Date 2/12/2026
Facility Type Physician Office
Lab Director SINNATHURAI VASANTHAKUMAR

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