11D0871024 CLIA NUMBER - DUSHYANT J PATEL MD

Laboratory Demographics

  • CLIA Code: 11D0871024
  • Facility Name: DUSHYANT J PATEL MD
  • Facility Address: 1020 WEST BRYAN STREET PO BOX 1949
    DOUGLAS, GA
    ZIP 31533
  • Facility Phone: 912 384-2469
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DUSHYANT J. PATEL
  • NPI Number: 1609869114
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D0871024
LAB Type Physician Office
Facility Name DUSHYANT J PATEL MD
Street 1020 WEST BRYAN STREET PO BOX 1949
City DOUGLAS
State GA
ZIP 31533
Phone 912 384-2469
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 DUSHYANT J. PATEL

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