11D0881823 CLIA NUMBER - TYRONE FAMILY MEDICINE, PC

Laboratory Demographics

  • CLIA Code: 11D0881823
  • Facility Name: TYRONE FAMILY MEDICINE, PC
  • Facility Address: 110 LLOYD AVENUE
    TYRONE, GA
    ZIP 30290
  • Facility Phone: (770) 486-1200
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CECIL F. BENNETT
  • NPI Number: 1922041714
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D0881823
LAB Type Physician Office
Facility Name TYRONE FAMILY MEDICINE, PC
Street 110 LLOYD AVENUE
City TYRONE
State GA
ZIP 30290
Phone 7704861200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/25/2025
Certificate Expiration Date 7/24/2027
Facility Type Physician Office
Lab Director CECIL F. BENNETT

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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