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11D1089837 CLIA NUMBER - SAVANNAH RIVER DERMATOLOGY LLC

Laboratory Demographics

CLIA Number: 11D1089837

Facility Name: SAVANNAH RIVER DERMATOLOGY LLC

Facility Address:
575 FURYS FERRY ROAD
MARTINEZ, GA
ZIP 30907
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Facility Phone Number: 706 922-6127

Facility Type: Physician Office

Certificate Type: Certificate of Compliance
NPI Number: 1982103875

Taxonomy: 106S00000X - Behavior Technician
The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work.

CLIA Record

Field Name Field Value
CLIA Number 11D1089837
LAB Type Physician Office
Facility Name SAVANNAH RIVER DERMATOLOGY LLC
Street 575 FURYS FERRY ROAD
City MARTINEZ
State GA
ZIP 30907
Phone 706 922-6127
CertificateType 2
CertificateEffectiveDate 10/21/2022
CertificateExpirationDate 10/20/2024
FacilityType Compliance

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