11D0924205 CLIA NUMBER - SHASHI G MADAN MD PC

Laboratory Demographics

  • CLIA Code: 11D0924205
  • Facility Name: SHASHI G MADAN MD PC
  • Facility Address: 135 NORTH OAK ST
    JACKSON, GA
    ZIP 30233
  • Facility Phone: 770 775-7676
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHASHI G. MADAN
  • NPI Number: 1740359629
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0924205
LAB Type Physician Office
Facility Name SHASHI G MADAN MD PC
Street 135 NORTH OAK ST
City JACKSON
State GA
ZIP 30233
Phone 770 775-7676
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/22/2025
Certificate Expiration Date 1/21/2027
Facility Type Physician Office
Lab Director SHASHI G. MADAN

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