11D1021992 CLIA NUMBER - PHOEBE SUMTER CARDIOLOGY/NEUROLOGY ASSOC

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Laboratory Demographics

CLIA Number: 11D1021992

Facility Name: PHOEBE SUMTER CARDIOLOGY/NEUROLOGY ASSOC

Facility Address:
120 HIGHWAY 28 D WEST SUITE B
AMERICUS, GA
ZIP 31719
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Facility Phone Number: 229 928-4144

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1417183781

Taxonomy: 3336I0012X - Pharmacy
A pharmacy in a hospital (inpatient) or institution used by pharmacists for the compounding and delivery of medicinal preparations to be administered to the patient by nursing or other authorized personnel. Institutional Pharmacies also counsel patients and caregivers; administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	11D1021992
LAB Type	Physician Office
Facility Name	PHOEBE SUMTER CARDIOLOGY/NEUROLOGY ASSOC
Street	120 HIGHWAY 28 D WEST SUITE B
City	AMERICUS
State	GA
ZIP	31719
Phone	229 928-4144
CertificateType	4
CertificateEffectiveDate	6/24/2023
CertificateExpirationDate	6/23/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024