11D1011118 CLIA NUMBER - ST JOSEPH CLINIC PC

Laboratory Demographics

  • CLIA Code: 11D1011118
  • Facility Name: ST JOSEPH CLINIC PC
  • Facility Address: 1102 WEST WAUGH STREET
    DALTON, GA
    ZIP 30720
  • Facility Phone: 706 227-2321
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PABLO E. PEREZ
  • NPI Number: 1841571718
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D1011118
LAB Type Physician Office
Facility Name ST JOSEPH CLINIC PC
Street 1102 WEST WAUGH STREET
City DALTON
State GA
ZIP 30720
Phone 706 227-2321
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/14/2023
Certificate Expiration Date 11/13/2025
Facility Type Physician Office
Lab Director PABLO E. PEREZ

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