11D0701021 CLIA NUMBER - ARCHBOLD PRIMARY CARE- CAIRO

Laboratory Demographics

  • CLIA Code: 11D0701021
  • Facility Name: ARCHBOLD PRIMARY CARE- CAIRO
  • Facility Address: 1090 5TH STREET, S E
    CAIRO, GA
    ZIP 39828
  • Facility Phone: 229 377-1100
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JASON M. NESMITH
  • NPI Number: 1265798185
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0701021
LAB Type Physician Office
Facility Name ARCHBOLD PRIMARY CARE- CAIRO
Street 1090 5TH STREET, S E
City CAIRO
State GA
ZIP 39828
Phone 229 377-1100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/8/2025
Certificate Expiration Date 9/7/2027
Facility Type Physician Office
Lab Director JASON M. NESMITH

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