11D0667010 CLIA NUMBER - SANDERSVILLE FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 11D0667010
  • Facility Name: SANDERSVILLE FAMILY PRACTICE
  • Facility Address: 205 MEDICAL ARTS DRIVE
    SANDERSVILLE, GA
    ZIP 31082
  • Facility Phone: 478 552-2020
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. EDWARD C. MCDAVID
  • NPI Number: 1538340914
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0667010
LAB Type Physician Office
Facility Name SANDERSVILLE FAMILY PRACTICE
Street 205 MEDICAL ARTS DRIVE
City SANDERSVILLE
State GA
ZIP 31082
Phone 478 552-2020
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 3/20/2025
Certificate Expiration Date 3/19/2027
Facility Type Physician Office
Lab Director DR. EDWARD C. MCDAVID

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