11D0966641 CLIA NUMBER - RICHARD BLOOM MD LLC

Laboratory Demographics

  • CLIA Code: 11D0966641
  • Facility Name: RICHARD BLOOM MD LLC
  • Facility Address: 1900 HAMILTON ROAD
    COLUMBUS, GA
    ZIP 31904
  • Facility Phone: 706 576-4474
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RICHARD R. BLOOM
  • NPI Number: 1952481251
  • Taxonomy: 208600000X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 11D0966641
LAB Type Physician Office
Facility Name RICHARD BLOOM MD LLC
Street 1900 HAMILTON ROAD
City COLUMBUS
State GA
ZIP 31904
Phone 706 576-4474
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/22/2023
Certificate Expiration Date 10/21/2025
Facility Type Physician Office
Lab Director RICHARD R. BLOOM

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