11D1011612 CLIA NUMBER - MEDI THRIFT INCORPORATE

Laboratory Demographics

  • CLIA Code: 11D1011612
  • Facility Name: MEDI THRIFT INCORPORATE
  • Facility Address: WEST PATTON STREET
    LAFAYETTE, GA
    ZIP 30728
  • Facility Phone: 706 638-3114
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CAROLYN L. FLORENCE
  • NPI Number: 1790840619
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D1011612
LAB Type Pharmacy
Facility Name MEDI THRIFT INCORPORATE
Street WEST PATTON STREET
City LAFAYETTE
State GA
ZIP 30728
Phone 706 638-3114
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/16/2025
Certificate Expiration Date 4/15/2027
Facility Type Pharmacy
Lab Director CAROLYN L. FLORENCE

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