11D0867500 CLIA NUMBER - WEST GEORGIA HOME CARE

Laboratory Demographics

  • CLIA Code: 11D0867500
  • Facility Name: WEST GEORGIA HOME CARE
  • Facility Address: 1 A NOK PLACE
    LAGRANGE, GA
    ZIP 30240
  • Facility Phone: (706) 845-3291
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: DAVID E. MARTIN MD
  • NPI Number: 1558594887
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 11D0867500
LAB Type Home Health Agency
Facility Name WEST GEORGIA HOME CARE
Street 1 A NOK PLACE
City LAGRANGE
State GA
ZIP 30240
Phone 7068453291
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 Home Health Agency
Lab Director DAVID E. MARTIN MD

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This page was last updated on: 5/18/2026