11D1073630 CLIA NUMBER - CHRIST COMMUNITY HEALTH SERVICES AUGUSTA INC

Laboratory Demographics

CLIA Number: 11D1073630

Facility Name: CHRIST COMMUNITY HEALTH SERVICES AUGUSTA INC

Facility Address:
1226 D ANTIGNAL STREET
AUGUSTA, GA
ZIP 30901
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Facility Phone Number: 706 922-0600

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1073192985

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D1073630
LAB Type	Physician Office
Facility Name	CHRIST COMMUNITY HEALTH SERVICES AUGUSTA INC
Street	1226 D ANTIGNAL STREET
City	AUGUSTA
State	GA
ZIP	30901
Phone	706 922-0600
CertificateType	3
CertificateEffectiveDate	9/13/2023
CertificateExpirationDate	9/12/2025
FacilityType	PPMP

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