11D1025255 CLIA NUMBER - STACY DAVIS, MD, PC

Laboratory Demographics

  • CLIA Code: 11D1025255
  • Facility Name: STACY DAVIS, MD, PC
  • Facility Address: 1450 WINTER STREET
    AUGUSTA, GA
    ZIP 30904
  • Facility Phone: (706) 364-3371
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STACY C. DAVIS
  • NPI Number: 1386746378
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D1025255
LAB Type Physician Office
Facility Name STACY DAVIS, MD, PC
Street 1450 WINTER STREET
City AUGUSTA
State GA
ZIP 30904
Phone 7063643371
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/4/2026
Certificate Expiration Date 5/3/2028
Facility Type Physician Office
Lab Director STACY C. DAVIS

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