11D1063615 CLIA NUMBER - FORREST J DOUD MD PC

Laboratory Demographics

  • CLIA Code: 11D1063615
  • Facility Name: FORREST J DOUD MD PC
  • Facility Address: 761 N CHEROKEE ROAD SUITE B
    SOCIAL CIRCLE, GA
    ZIP 30025
  • Facility Phone: 678 535-3030
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: FORREST J. DOUD MD
  • NPI Number: 1639127392
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D1063615
LAB Type Physician Office
Facility Name FORREST J DOUD MD PC
Street 761 N CHEROKEE ROAD SUITE B
City SOCIAL CIRCLE
State GA
ZIP 30025
Phone 678 535-3030
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 1/18/2025
Certificate Expiration Date 1/17/2027
Facility Type Physician Office
Lab Director FORREST J. DOUD MD

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