11D0702661 CLIA NUMBER - FCI JESUP GEORGIA

Laboratory Demographics

  • CLIA Code: 11D0702661
  • Facility Name: FCI JESUP GEORGIA
  • Facility Address: 2600 SOUTH US HWY 301
    JESUP, GA
    ZIP 31545
  • Facility Phone: 912 427-0870
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: DARREN MARTIN
  • NPI Number: 1508538679
  • Taxonomy: 261QP2400X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D0702661
LAB Type Other
Facility Name FCI JESUP GEORGIA
Street 2600 SOUTH US HWY 301
City JESUP
State GA
ZIP 31545
Phone 912 427-0870
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/17/2024
Certificate Expiration Date 7/16/2026
Facility Type Other
Lab Director DARREN MARTIN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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