11D1076336 CLIA NUMBER - CARECONNECT FAMILY PRACTICE AND PEDIATRICS

Laboratory Demographics

  • CLIA Code: 11D1076336
  • Facility Name: CARECONNECT FAMILY PRACTICE AND PEDIATRICS
  • Facility Address: 636 2ND AVENUE SW
    ROCHELLE, GA
    ZIP 31079
  • Facility Phone: 229 365-2570
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: BRIDGET MOSLEY
  • NPI Number: 1144401787
  • Taxonomy: 261QF0400X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D1076336
LAB Type Federally Qualified Health Center
Facility Name CARECONNECT FAMILY PRACTICE AND PEDIATRICS
Street 636 2ND AVENUE SW
City ROCHELLE
State GA
ZIP 31079
Phone 229 365-2570
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/13/2023
Certificate Expiration Date 11/12/2025
Facility Type Federally Qualified Health Center
Lab Director BRIDGET MOSLEY

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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