11D0705368 CLIA NUMBER - THOMASTON PEDIATRICS PC

Laboratory Demographics

  • CLIA Code: 11D0705368
  • Facility Name: THOMASTON PEDIATRICS PC
  • Facility Address: 403 WEST GORDON STREET
    THOMASTON, GA
    ZIP 30286
  • Facility Phone: 706 647-1680
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KEVIN L. DELLI-GATTI
  • NPI Number: 1881850139
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D0705368
LAB Type Physician Office
Facility Name THOMASTON PEDIATRICS PC
Street 403 WEST GORDON STREET
City THOMASTON
State GA
ZIP 30286
Phone 706 647-1680
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 KEVIN L. DELLI-GATTI

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