11D0915858 CLIA NUMBER - FORT GAINES HEALTHCARE

Laboratory Demographics

  • CLIA Code: 11D0915858
  • Facility Name: FORT GAINES HEALTHCARE
  • Facility Address: 101 HARTFORD ROAD, W
    FORT GAINES, GA
    ZIP 39851
  • Facility Phone: 912 768-2521
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ABDOLLATIF GHIATHI
  • NPI Number: 1750553996
  • Taxonomy: 314000000X - Skilled Nursing Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D0915858
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name FORT GAINES HEALTHCARE
Street 101 HARTFORD ROAD, W
City FORT GAINES
State GA
ZIP 39851
Phone 912 768-2521
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/10/2024
Certificate Expiration Date 6/9/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director ABDOLLATIF GHIATHI

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: 9/29/2025