11D1078165 CLIA NUMBER - CHATTOOGA COUNTY JAIL

Laboratory Demographics

CLIA Number: 11D1078165

Facility Name: CHATTOOGA COUNTY JAIL

Facility Address:
35 W WASHINGTON STREET
SUMMERVILLE, GA
ZIP 30747
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Facility Phone Number: 770 692-4750

Facility Type: Other - COUNTY JAIL

Certificate Type: Waiver

NPI Number: 1124137211

Taxonomy: 3416L0300X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	11D1078165
LAB Type	Other - COUNTY JAIL
Facility Name	CHATTOOGA COUNTY JAIL
Street	35 W WASHINGTON STREET
City	SUMMERVILLE
State	GA
ZIP	30747
Phone	770 692-4750
CertificateType	4
CertificateEffectiveDate	7/13/2022
CertificateExpirationDate	7/12/2024
FacilityType	Waiver

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