11D0996398 CLIA NUMBER - COLUMBUS PRIMARY CARE INTERNAL MEDICINE PC

Laboratory Demographics

  • CLIA Code: 11D0996398
  • Facility Name: COLUMBUS PRIMARY CARE INTERNAL MEDICINE PC
  • Facility Address: 1041 TALBOTTON ROAD
    COLUMBUS, GA
    ZIP 31904
  • Facility Phone: 706 660-8825
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: EDET O. BASSEY
  • NPI Number: 1063566909
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0996398
LAB Type Physician Office
Facility Name COLUMBUS PRIMARY CARE INTERNAL MEDICINE PC
Street 1041 TALBOTTON ROAD
City COLUMBUS
State GA
ZIP 31904
Phone 706 660-8825
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 2/18/2024
Certificate Expiration Date 2/17/2026
Facility Type Physician Office
Lab Director EDET O. BASSEY

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