11D0928567 CLIA NUMBER - JORGE L MORENO MD

Laboratory Demographics

  • CLIA Code: 11D0928567
  • Facility Name: JORGE L MORENO MD
  • Facility Address: 375 MCDONOUGH ROAD
    JACKSON, GA
    ZIP 30233
  • Facility Phone: 770 775-4622
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JORGE L. MORENO
  • NPI Number: 1518914597
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0928567
LAB Type Physician Office
Facility Name JORGE L MORENO MD
Street 375 MCDONOUGH ROAD
City JACKSON
State GA
ZIP 30233
Phone 770 775-4622
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/21/2025
Certificate Expiration Date 5/20/2027
Facility Type Physician Office
Lab Director JORGE L. MORENO

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