11D0686564 CLIA NUMBER - MARK R HARVEY MD PC

Laboratory Demographics

  • CLIA Code: 11D0686564
  • Facility Name: MARK R HARVEY MD PC
  • Facility Address: 203 MEDICAL ARTS PLACE STE 3
    SANDERSVILLE, GA
    ZIP 31082
  • Facility Phone: 912 552-0967
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MARK R. HARVEY
  • NPI Number: 1053421172
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0686564
LAB Type Physician Office
Facility Name MARK R HARVEY MD PC
Street 203 MEDICAL ARTS PLACE STE 3
City SANDERSVILLE
State GA
ZIP 31082
Phone 912 552-0967
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 3/10/2024
Certificate Expiration Date 3/9/2026
Facility Type Physician Office
Lab Director MARK R. HARVEY

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