11D0646042 CLIA NUMBER - AUTUMN LANE HEALTH & REHABILITATION

Laboratory Demographics

  • CLIA Code: 11D0646042
  • Facility Name: AUTUMN LANE HEALTH & REHABILITATION
  • Facility Address: 302 GEORGIA 18 EAST
    GRAY, GA
    ZIP 31032
  • Facility Phone: 478 986-3151
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: MAULIKKUMAR PATEL
  • NPI Number: 1043253172
  • Taxonomy: 314000000X - Skilled Nursing Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D0646042
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name AUTUMN LANE HEALTH & REHABILITATION
Street 302 GEORGIA 18 EAST
City GRAY
State GA
ZIP 31032
Phone 478 986-3151
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director MAULIKKUMAR PATEL

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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