11D0677873 CLIA NUMBER - PINELAND MENTAL HEALTH DEVELOPMENTAL DISABILITIES AND ADDICTIVE DISEASE CSB

Laboratory Demographics

  • CLIA Code: 11D0677873
  • Facility Name: PINELAND MENTAL HEALTH DEVELOPMENTAL DISABILITIES AND ADDICTIVE DISEASE CSB
  • Facility Address: 4 WEST ALTMAN STREET
    STATESBORO, GA
    ZIP 30458
  • Facility Phone: 912 764-6906
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: JUNE A. DIPOLITO
  • NPI Number: 1053570762
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D0677873
LAB Type Community Clinic
Facility Name PINELAND MENTAL HEALTH DEVELOPMENTAL DISABILITIES AND ADDICTIVE DISEASE CSB
Street 4 WEST ALTMAN STREET
City STATESBORO
State GA
ZIP 30458
Phone 912 764-6906
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 Community Clinic
Lab Director JUNE A. DIPOLITO

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