11D0695246 CLIA NUMBER - MIDDLE GEORGIA MEDICAL ASSOCIATES PC

Laboratory Demographics

CLIA Number: 11D0695246

Facility Name: MIDDLE GEORGIA MEDICAL ASSOCIATES PC

Facility Address:
623 SOUTH HOUSTON LAKE ROAD, SUITE 200
WARNER ROBINS, GA
ZIP 31088
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Facility Phone Number: 478 923-6633

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1992751911

Taxonomy: 207RP1001X - Internal Medicine
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

CLIA Record

Field Name	Field Value
CLIA Number	11D0695246
LAB Type	Physician Office
Facility Name	MIDDLE GEORGIA MEDICAL ASSOCIATES PC
Street	623 SOUTH HOUSTON LAKE ROAD, SUITE 200
City	WARNER ROBINS
State	GA
ZIP	31088
Phone	478 923-6633
CertificateType	4
CertificateEffectiveDate	2/21/2024
CertificateExpirationDate	2/20/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024