11D1038778 CLIA NUMBER - SOUTHERNCARE, INC DBA HEARTLAND HOSPICE (AUGUSTA)

Laboratory Demographics

  • CLIA Code: 11D1038778
  • Facility Name: SOUTHERNCARE, INC DBA HEARTLAND HOSPICE (AUGUSTA)
  • Facility Address: 4487 COLUMBIA ROAD, SUITE 103
    MARTINEZ, GA
    ZIP 30907
  • Facility Phone: 706 860-7374
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: MS. SELECE BEASLEY
  • NPI Number: 1720787211
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 11D1038778
LAB Type Hospice
Facility Name SOUTHERNCARE, INC DBA HEARTLAND HOSPICE (AUGUSTA)
Street 4487 COLUMBIA ROAD, SUITE 103
City MARTINEZ
State GA
ZIP 30907
Phone 706 860-7374
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/28/2025
Certificate Expiration Date 3/27/2027
Facility Type Hospice
Lab Director MS. SELECE BEASLEY

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