11D1047874 CLIA NUMBER - SOUTH ALBANY MEDICAL CENTER

Laboratory Demographics

CLIA Number: 11D1047874

Facility Name: SOUTH ALBANY MEDICAL CENTER

Facility Address:
1300 NEWTON ROAD
ALBANY, GA
ZIP 31701
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Facility Phone Number: 229 883-6860

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy

NPI Number: 1023043692

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D1047874
LAB Type	Federally Qualified Health Center
Facility Name	SOUTH ALBANY MEDICAL CENTER
Street	1300 NEWTON ROAD
City	ALBANY
State	GA
ZIP	31701
Phone	229 883-6860
CertificateType	3
CertificateEffectiveDate	11/16/2023
CertificateExpirationDate	11/15/2025
FacilityType	PPMP

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