11D0869932 CLIA NUMBER - LAGRANGE INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 11D0869932
  • Facility Name: LAGRANGE INTERNAL MEDICINE
  • Facility Address: 1602 VERNON ROAD SUITE 400
    LAGRANGE, GA
    ZIP 30240
  • Facility Phone: 706 298-2648
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: ARNOLD SMALLS
  • NPI Number: 1053787515
  • Taxonomy: 213E00000X - Podiatrist

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CLIA Record

Field Name Field Value
CLIA Number 11D0869932
LAB Type Physician Office
Facility Name LAGRANGE INTERNAL MEDICINE
Street 1602 VERNON ROAD SUITE 400
City LAGRANGE
State GA
ZIP 30240
Phone 706 298-2648
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 7/1/2024
Certificate Expiration Date 6/30/2026
Facility Type Physician Office
Lab Director ARNOLD SMALLS

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