11D1094211 CLIA NUMBER - COOPERATIVE HEALTHCARE SERVICES INCORPORATED DBA GLYNN FAMILY MEDICINE CENTER

Laboratory Demographics

CLIA Number: 11D1094211

Facility Name: COOPERATIVE HEALTHCARE SERVICES INCORPORATED DBA GLYNN FAMILY MEDICINE CENTER

Facility Address:
3222 A SHRINE ROAD
BRUNSWICK, GA
ZIP 31520
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Facility Phone Number: 912 264-6303

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1336163096

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D1094211
LAB Type	Physician Office
Facility Name	COOPERATIVE HEALTHCARE SERVICES INCORPORATED DBA GLYNN FAMILY MEDICINE CENTER
Street	3222 A SHRINE ROAD
City	BRUNSWICK
State	GA
ZIP	31520
Phone	912 264-6303
CertificateType	3
CertificateEffectiveDate	1/14/2023
CertificateExpirationDate	1/13/2025
FacilityType	PPMP

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