11D0954160 CLIA NUMBER - JEFFERSON PEDIATRICS INC PEDIATRIC AND ADOLESCENT MEDICINE

Laboratory Demographics

  • CLIA Code: 11D0954160
  • Facility Name: JEFFERSON PEDIATRICS INC PEDIATRIC AND ADOLESCENT MEDICINE
  • Facility Address: 2610 US HWY 129 NORTH
    JEFFERSON, GA
    ZIP 30549
  • Facility Phone: 706 367-1010
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: TAMMY G. SMITH
  • NPI Number: 1336411347
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D0954160
LAB Type Physician Office
Facility Name JEFFERSON PEDIATRICS INC PEDIATRIC AND ADOLESCENT MEDICINE
Street 2610 US HWY 129 NORTH
City JEFFERSON
State GA
ZIP 30549
Phone 706 367-1010
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 5/26/2025
Certificate Expiration Date 5/25/2027
Facility Type Physician Office
Lab Director TAMMY G. SMITH

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