11D1055895 CLIA NUMBER - SOUTHERNCARE, INC DBA HEARTLAND HOSPICE BRUNSWICK

Laboratory Demographics

  • CLIA Code: 11D1055895
  • Facility Name: SOUTHERNCARE, INC DBA HEARTLAND HOSPICE BRUNSWICK
  • Facility Address: 664 SCRANTON ROAD, UNIT 103
    BRUNSWICK, GA
    ZIP 31520
  • Facility Phone: 912 261-8760
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: SELECE BEASLEY
  • NPI Number: 1720787229
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 11D1055895
LAB Type Hospice
Facility Name SOUTHERNCARE, INC DBA HEARTLAND HOSPICE BRUNSWICK
Street 664 SCRANTON ROAD, UNIT 103
City BRUNSWICK
State GA
ZIP 31520
Phone 912 261-8760
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/29/2024
Certificate Expiration Date 6/28/2026
Facility Type Hospice
Lab Director SELECE BEASLEY

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