11D1028949 CLIA NUMBER - BRUNSWICK JOB CORPS

Laboratory Demographics

CLIA Number: 11D1028949

Facility Name: BRUNSWICK JOB CORPS

Facility Address:
4401 GLYNCO PARKWAY, WELLNESS CENTER
BRUNSWICK, GA
ZIP 31525
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Facility Phone Number: 912 264-8843

Facility Type: School/Student Health Service

Certificate Type: Waiver

NPI Number: 1154422541

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D1028949
LAB Type	School/Student Health Service
Facility Name	BRUNSWICK JOB CORPS
Street	4401 GLYNCO PARKWAY, WELLNESS CENTER
City	BRUNSWICK
State	GA
ZIP	31525
Phone	912 264-8843
CertificateType	4
CertificateEffectiveDate	8/5/2022
CertificateExpirationDate	8/4/2024
FacilityType	Waiver

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