11D0266106 CLIA NUMBER - JAMES E LUCKIE JR DO

Laboratory Demographics

  • CLIA Code: 11D0266106
  • Facility Name: JAMES E LUCKIE JR DO
  • Facility Address: 182 PERRY HOUSE RD
    FITZGERALD, GA
    ZIP 31750
  • Facility Phone: 912 423-8725
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JAMES E. LUCKIE
  • NPI Number: 1093725079
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0266106
LAB Type Physician Office
Facility Name JAMES E LUCKIE JR DO
Street 182 PERRY HOUSE RD
City FITZGERALD
State GA
ZIP 31750
Phone 912 423-8725
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director JAMES E. LUCKIE

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