11D1006249 CLIA NUMBER - SAN PABLO MEDICAL CLINIC, LLC

Laboratory Demographics

  • CLIA Code: 11D1006249
  • Facility Name: SAN PABLO MEDICAL CLINIC, LLC
  • Facility Address: 1906 SHIELDS ROAD
    DALTON, GA
    ZIP 30720
  • Facility Phone: 706 270-5990
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: JULIA GARCIA MD
  • NPI Number: 1619037769
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D1006249
LAB Type Rural Health Clinic
Facility Name SAN PABLO MEDICAL CLINIC, LLC
Street 1906 SHIELDS ROAD
City DALTON
State GA
ZIP 30720
Phone 706 270-5990
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/13/2024
Certificate Expiration Date 11/12/2026
Facility Type Rural Health Clinic
Lab Director JULIA GARCIA MD

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