11D1010631 CLIA NUMBER - MIDTOWN OB GYN

Laboratory Demographics

  • CLIA Code: 11D1010631
  • Facility Name: MIDTOWN OB GYN
  • Facility Address: 1538 13TH AVENUE SUITE C-200
    COLUMBUS, GA
    ZIP 31901
  • Facility Phone: 706 320-2547
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SERENA TIDWELL
  • NPI Number: 1033141031
  • Taxonomy: 174400000X - Specialist

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D1010631
LAB Type Physician Office
Facility Name MIDTOWN OB GYN
Street 1538 13TH AVENUE SUITE C-200
City COLUMBUS
State GA
ZIP 31901
Phone 706 320-2547
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/25/2025
Certificate Expiration Date 1/24/2027
Facility Type Physician Office
Lab Director SERENA TIDWELL

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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