11D0885502 CLIA NUMBER - BROWN FAMILY PRACTICE, LLC

Laboratory Demographics

  • CLIA Code: 11D0885502
  • Facility Name: BROWN FAMILY PRACTICE, LLC
  • Facility Address: 701 BLUE BIRD BLVD
    FORT VALLEY, GA
    ZIP 31030
  • Facility Phone: 478 827-1971
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. CRYSTAL L. BROWN
  • NPI Number: 1013257633
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D0885502
LAB Type Physician Office
Facility Name BROWN FAMILY PRACTICE, LLC
Street 701 BLUE BIRD BLVD
City FORT VALLEY
State GA
ZIP 31030
Phone 478 827-1971
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 4/22/2024
Certificate Expiration Date 4/21/2026
Facility Type Physician Office
Lab Director DR. CRYSTAL L. BROWN

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