11D0987724 CLIA NUMBER - TIFTAREA CARDIOLOGY PC

Laboratory Demographics

  • CLIA Code: 11D0987724
  • Facility Name: TIFTAREA CARDIOLOGY PC
  • Facility Address: 907 E 18TH STREET SUITE 100
    TIFTON, GA
    ZIP 31794
  • Facility Phone: 912 391-9980
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WILLIAM W. HANCOCK MD
  • NPI Number: 1912068503
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 11D0987724
LAB Type Physician Office
Facility Name TIFTAREA CARDIOLOGY PC
Street 907 E 18TH STREET SUITE 100
City TIFTON
State GA
ZIP 31794
Phone 912 391-9980
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/12/2025
Certificate Expiration Date 6/11/2027
Facility Type Physician Office
Lab Director WILLIAM W. HANCOCK MD

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