11D1038369 CLIA NUMBER - BARNEYS SPECIALTY MEDICAL INCORPORATE

Laboratory Demographics

  • CLIA Code: 11D1038369
  • Facility Name: BARNEYS SPECIALTY MEDICAL INCORPORATE
  • Facility Address: 2604 PEACH ORCHARD ROAD, SUITE 100
    AUGUSTA, GA
    ZIP 30906
  • Facility Phone: 706 798-5645
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ASHLEY S. LONDON
  • NPI Number: 1073854741
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D1038369
LAB Type Pharmacy
Facility Name BARNEYS SPECIALTY MEDICAL INCORPORATE
Street 2604 PEACH ORCHARD ROAD, SUITE 100
City AUGUSTA
State GA
ZIP 30906
Phone 706 798-5645
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/29/2024
Certificate Expiration Date 3/28/2026
Facility Type Pharmacy
Lab Director ASHLEY S. LONDON

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