11D1093633 CLIA NUMBER - KEVIN M HOLLOWAY MD

Laboratory Demographics

  • CLIA Code: 11D1093633
  • Facility Name: KEVIN M HOLLOWAY MD
  • Facility Address: 110 4TH AVENUE EAST
    CORDELE, GA
    ZIP 31015
  • Facility Phone: 229 276-2190
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: KEVIN M. HOLLOWAY MD
  • NPI Number: 1114107810
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D1093633
LAB Type Physician Office
Facility Name KEVIN M HOLLOWAY MD
Street 110 4TH AVENUE EAST
City CORDELE
State GA
ZIP 31015
Phone 229 276-2190
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 12/29/2024
Certificate Expiration Date 12/28/2026
Facility Type Physician Office
Lab Director KEVIN M. HOLLOWAY MD

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