11D0977399 CLIA NUMBER - COLQUITT COMPLETE CARE, LLC

Laboratory Demographics

  • CLIA Code: 11D0977399
  • Facility Name: COLQUITT COMPLETE CARE, LLC
  • Facility Address: 103 WEST PINE STREET
    COLQUITT, GA
    ZIP 39837
  • Facility Phone: 229 758-3002
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: WILLIAM SWOFFORD
  • NPI Number: 1265602940
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0977399
LAB Type Physician Office
Facility Name COLQUITT COMPLETE CARE, LLC
Street 103 WEST PINE STREET
City COLQUITT
State GA
ZIP 39837
Phone 229 758-3002
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/25/2024
Certificate Expiration Date 8/24/2026
Facility Type Physician Office
Lab Director WILLIAM SWOFFORD

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