11D0700939 CLIA NUMBER - AUGUSTA RENAL PHYSICIANS PC

Laboratory Demographics

  • CLIA Code: 11D0700939
  • Facility Name: AUGUSTA RENAL PHYSICIANS PC
  • Facility Address: 1109 MEDICAL CENTER DRIVE BLDG #5
    AUGUSTA, GA
    ZIP 30909
  • Facility Phone: 706 863-6637
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MICHAEL L. WHITLOW
  • NPI Number: 1396786760
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0700939
LAB Type Physician Office
Facility Name AUGUSTA RENAL PHYSICIANS PC
Street 1109 MEDICAL CENTER DRIVE BLDG #5
City AUGUSTA
State GA
ZIP 30909
Phone 706 863-6637
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 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director MICHAEL L. WHITLOW

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