11D0990587 CLIA NUMBER - CENTRAL GEORGIA INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 11D0990587
  • Facility Name: CENTRAL GEORGIA INTERNAL MEDICINE
  • Facility Address: 640 1ST STREET ATTN STARLETT BROWN
    MACON, GA
    ZIP 31201
  • Facility Phone: 478 745-7696
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MUHAMMED REHAN
  • NPI Number: 1467523084
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0990587
LAB Type Physician Office
Facility Name CENTRAL GEORGIA INTERNAL MEDICINE
Street 640 1ST STREET ATTN STARLETT BROWN
City MACON
State GA
ZIP 31201
Phone 478 745-7696
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/10/2025
Certificate Expiration Date 8/9/2027
Facility Type Physician Office
Lab Director MUHAMMED REHAN

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