11D0873106 CLIA NUMBER - CENTER FOR PRIMARY CARE CENTRAL

Laboratory Demographics

  • CLIA Code: 11D0873106
  • Facility Name: CENTER FOR PRIMARY CARE CENTRAL
  • Facility Address: 3614-D J DEWEY GRAY CIRCLE
    AUGUSTA, GA
    ZIP 30909
  • Facility Phone: 706 868-7380
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: DR. PHILLIP KENNEDY
  • NPI Number: 1992824205
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D0873106
LAB Type Physician Office
Facility Name CENTER FOR PRIMARY CARE CENTRAL
Street 3614-D J DEWEY GRAY CIRCLE
City AUGUSTA
State GA
ZIP 30909
Phone 706 868-7380
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 10/2/2024
Certificate Expiration Date 10/1/2026
Facility Type Physician Office
Lab Director DR. PHILLIP KENNEDY

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