11D1058993 CLIA NUMBER - BOWMAN PAIN MANAGEMENT CENTER PC

Laboratory Demographics

  • CLIA Code: 11D1058993
  • Facility Name: BOWMAN PAIN MANAGEMENT CENTER PC
  • Facility Address: 6010 LAKESIDE COMMONS DRIVE SUITE B
    MACON, GA
    ZIP 31210
  • Facility Phone: 478 475-9220
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DWAYNE L. CLAY
  • NPI Number: 1417979550
  • Taxonomy: 261QP3300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D1058993
LAB Type Ambulatory Surgery Center
Facility Name BOWMAN PAIN MANAGEMENT CENTER PC
Street 6010 LAKESIDE COMMONS DRIVE SUITE B
City MACON
State GA
ZIP 31210
Phone 478 475-9220
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/20/2024
Certificate Expiration Date 9/19/2026
Facility Type Ambulatory Surgery Center
Lab Director DWAYNE L. CLAY

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