11D0996848 CLIA NUMBER - PEDIATRICS AT BROOKSTONE CENTRE, PC

Laboratory Demographics

  • CLIA Code: 11D0996848
  • Facility Name: PEDIATRICS AT BROOKSTONE CENTRE, PC
  • Facility Address: 2001 BROOKSTONE CENTRE PARKWAY
    COLUMBUS, GA
    ZIP 31904
  • Facility Phone: 706 571-9699
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RICHARD H. MANSFIELD
  • NPI Number: 1215989462
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D0996848
LAB Type Physician Office
Facility Name PEDIATRICS AT BROOKSTONE CENTRE, PC
Street 2001 BROOKSTONE CENTRE PARKWAY
City COLUMBUS
State GA
ZIP 31904
Phone 706 571-9699
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/29/2025
Certificate Expiration Date 3/28/2027
Facility Type Physician Office
Lab Director RICHARD H. MANSFIELD

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