11D0939739 CLIA NUMBER - ELBERT COUNTY INTERNAL MEDICINE LLC

Laboratory Demographics

  • CLIA Code: 11D0939739
  • Facility Name: ELBERT COUNTY INTERNAL MEDICINE LLC
  • Facility Address: 740 PRINCE AVENUE BUILDING 13
    ATHENS, GA
    ZIP 30606
  • Facility Phone: 706 549-8682
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GEORGE CLELAND MD
  • NPI Number: 1427397082
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0939739
LAB Type Physician Office
Facility Name ELBERT COUNTY INTERNAL MEDICINE LLC
Street 740 PRINCE AVENUE BUILDING 13
City ATHENS
State GA
ZIP 30606
Phone 706 549-8682
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/30/2024
Certificate Expiration Date 1/29/2026
Facility Type Physician Office
Lab Director GEORGE CLELAND MD

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