11D0959472 CLIA NUMBER - MEDICAL FOOT CARE CENTER

Laboratory Demographics

  • CLIA Code: 11D0959472
  • Facility Name: MEDICAL FOOT CARE CENTER
  • Facility Address: 211 REDMOND RD NW
    ROME, GA
    ZIP 30165
  • Facility Phone: 706 802-1800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BRIAN K. MIDDLETON
  • NPI Number: 1043494834
  • Taxonomy: 261QP1100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D0959472
LAB Type Physician Office
Facility Name MEDICAL FOOT CARE CENTER
Street 211 REDMOND RD NW
City ROME
State GA
ZIP 30165
Phone 706 802-1800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/13/2025
Certificate Expiration Date 4/12/2027
Facility Type Physician Office
Lab Director BRIAN K. MIDDLETON

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This page was last updated on: 6/4/2025