11D1081296 CLIA NUMBER - PRUITTHEALTH - ROME, LLC

Laboratory Demographics

  • CLIA Code: 11D1081296
  • Facility Name: PRUITTHEALTH - ROME, LLC
  • Facility Address: 2 THREE MILE ROAD
    ROME, GA
    ZIP 30165
  • Facility Phone: 706 236-6002
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DONNA J. CLARK
  • NPI Number: 1497176325
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 11D1081296
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PRUITTHEALTH - ROME, LLC
Street 2 THREE MILE ROAD
City ROME
State GA
ZIP 30165
Phone 706 236-6002
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/14/2024
Certificate Expiration Date 3/13/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director DONNA J. CLARK

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