11D0705016 CLIA NUMBER - JOSEPH M STILL BURN CENTER INCORPORATE

Laboratory Demographics

  • CLIA Code: 11D0705016
  • Facility Name: JOSEPH M STILL BURN CENTER INCORPORATE
  • Facility Address: 3675 J DEWEY GRAY CIR
    AUGUSTA, GA
    ZIP 30909
  • Facility Phone: 706 863-9595
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT MULLINS
  • NPI Number: 1891468518
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 11D0705016
LAB Type Physician Office
Facility Name JOSEPH M STILL BURN CENTER INCORPORATE
Street 3675 J DEWEY GRAY CIR
City AUGUSTA
State GA
ZIP 30909
Phone 706 863-9595
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 ROBERT MULLINS

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This page was last updated on: 6/4/2025