11D0695653 CLIA NUMBER - JAMES M FORD MD

Laboratory Demographics

  • CLIA Code: 11D0695653
  • Facility Name: JAMES M FORD MD
  • Facility Address: 501 BROAD STREET
    WRENS, GA
    ZIP 30833
  • Facility Phone: 706 547-2559
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAMES M. FORD
  • NPI Number: 1033117684
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0695653
LAB Type Physician Office
Facility Name JAMES M FORD MD
Street 501 BROAD STREET
City WRENS
State GA
ZIP 30833
Phone 706 547-2559
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 Physician Office
Lab Director JAMES M. FORD

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