11D0951815 CLIA NUMBER - BRADLEY PLACE

Laboratory Demographics

  • CLIA Code: 11D0951815
  • Facility Name: BRADLEY PLACE
  • Facility Address: 418 NORTH PARK AVE
    TIFTON, GA
    ZIP 31794
  • Facility Phone: 912 386-9789
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: WILLIAM C. BYRD
  • NPI Number: 1376601302
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 11D0951815
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name BRADLEY PLACE
Street 418 NORTH PARK AVE
City TIFTON
State GA
ZIP 31794
Phone 912 386-9789
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/29/2024
Certificate Expiration Date 9/28/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director WILLIAM C. BYRD

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