11D1097734 CLIA NUMBER - COLUMBUS MEMORY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 11D1097734
  • Facility Name: COLUMBUS MEMORY CENTER, LLC
  • Facility Address: 7196 NORTH LAKE DRIVE
    COLUMBUS, GA
    ZIP 31909
  • Facility Phone: 706 327-4000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JONATHAN L. LISS
  • NPI Number: 1083171607
  • Taxonomy: 2084N0400X - Psychiatry & Neurology

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D1097734
LAB Type Physician Office
Facility Name COLUMBUS MEMORY CENTER, LLC
Street 7196 NORTH LAKE DRIVE
City COLUMBUS
State GA
ZIP 31909
Phone 706 327-4000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/2/2025
Certificate Expiration Date 4/1/2027
Facility Type Physician Office
Lab Director JONATHAN L. LISS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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