11D1009198 CLIA NUMBER - DAVID KAVTARADZE, MD

Laboratory Demographics

  • CLIA Code: 11D1009198
  • Facility Name: DAVID KAVTARADZE, MD
  • Facility Address: 1008 N 7TH STREET
    CORDELE, GA
    ZIP 31015
  • Facility Phone: 229 271-4608
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. DAVID KAVTARADZE
  • NPI Number: 1376516484
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D1009198
LAB Type Physician Office
Facility Name DAVID KAVTARADZE, MD
Street 1008 N 7TH STREET
City CORDELE
State GA
ZIP 31015
Phone 229 271-4608
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/15/2024
Certificate Expiration Date 1/14/2026
Facility Type Physician Office
Lab Director DR. DAVID KAVTARADZE

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