11D1005138 CLIA NUMBER - VINEVILLE INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 11D1005138
  • Facility Name: VINEVILLE INTERNAL MEDICINE
  • Facility Address: 3448 VINEVILLE AVENUE
    MACON, GA
    ZIP 31204
  • Facility Phone: 478 405-0045
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: MARY BELL H. VAUGHN
  • NPI Number: 1396955431
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D1005138
LAB Type Physician Office
Facility Name VINEVILLE INTERNAL MEDICINE
Street 3448 VINEVILLE AVENUE
City MACON
State GA
ZIP 31204
Phone 478 405-0045
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 7/1/2024
Certificate Expiration Date 6/30/2026
Facility Type Physician Office
Lab Director MARY BELL H. VAUGHN

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