11D1021574 CLIA NUMBER - BAINBRIDGE MEDICAL ASSOCIATES

Laboratory Demographics

  • CLIA Code: 11D1021574
  • Facility Name: BAINBRIDGE MEDICAL ASSOCIATES
  • Facility Address: 1518 MILULI AVE
    BAINBRIDGE, GA
    ZIP 39819
  • Facility Phone: 229 298-8500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MALLORY MCRAE
  • NPI Number: 1104836493
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D1021574
LAB Type Physician Office
Facility Name BAINBRIDGE MEDICAL ASSOCIATES
Street 1518 MILULI AVE
City BAINBRIDGE
State GA
ZIP 39819
Phone 229 298-8500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/26/2024
Certificate Expiration Date 1/25/2026
Facility Type Physician Office
Lab Director MALLORY MCRAE

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