11D0996563 CLIA NUMBER - THOMAS D FAUSETT JR MD PC

Laboratory Demographics

  • CLIA Code: 11D0996563
  • Facility Name: THOMAS D FAUSETT JR MD PC
  • Facility Address: 707 N PARRISH AVENUE
    ADEL, GA
    ZIP 31620
  • Facility Phone: 229 896-7007
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: THOMAS D. FAUSETT
  • NPI Number: 1366513210
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0996563
LAB Type Physician Office
Facility Name THOMAS D FAUSETT JR MD PC
Street 707 N PARRISH AVENUE
City ADEL
State GA
ZIP 31620
Phone 229 896-7007
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 2/21/2024
Certificate Expiration Date 2/20/2026
Facility Type Physician Office
Lab Director THOMAS D. FAUSETT

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