11D0934297 CLIA NUMBER - HOUSTON FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 11D0934297
  • Facility Name: HOUSTON FAMILY MEDICINE
  • Facility Address: 106 MORAN DRIVE
    BONAIRE, GA
    ZIP 31005
  • Facility Phone: 478 988-1282
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SAMUEL E. PALMER
  • NPI Number: 1376555300
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0934297
LAB Type Physician Office
Facility Name HOUSTON FAMILY MEDICINE
Street 106 MORAN DRIVE
City BONAIRE
State GA
ZIP 31005
Phone 478 988-1282
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/3/2025
Certificate Expiration Date 4/2/2027
Facility Type Physician Office
Lab Director SAMUEL E. PALMER

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