11D1019456 CLIA NUMBER - HARBIN CLINIC SUMMERVILLE FAMILY PRACTICE LAB

Laboratory Demographics

  • CLIA Code: 11D1019456
  • Facility Name: HARBIN CLINIC SUMMERVILLE FAMILY PRACTICE LAB
  • Facility Address: 11766 HIGHWAY 27, SUITE A
    SUMMERVILLE, GA
    ZIP 30747
  • Facility Phone: (706) 734-2878
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BRUCE WYNN
  • NPI Number: 1861680118
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D1019456
LAB Type Physician Office
Facility Name HARBIN CLINIC SUMMERVILLE FAMILY PRACTICE LAB
Street 11766 HIGHWAY 27, SUITE A
City SUMMERVILLE
State GA
ZIP 30747
Phone 7067342878
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/19/2025
Certificate Expiration Date 11/18/2027
Facility Type Physician Office
Lab Director BRUCE WYNN

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This page was last updated on: 5/18/2026