11D1098764 CLIA NUMBER - ADVANCED GYNECOLOGY SPECIALISTS OF AUGUSTA

Laboratory Demographics

CLIA Number: 11D1098764

Facility Name: ADVANCED GYNECOLOGY SPECIALISTS OF AUGUSTA

Facility Address:
7013 EVANS TOWN CENTER BOULEVARD SUITE 101
EVANS, GA
ZIP 30809
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Facility Phone Number: 706 922-4545

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1619110574

Taxonomy: 207VG0400X - Obstetrics & Gynecology
A physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	11D1098764
LAB Type	Physician Office
Facility Name	ADVANCED GYNECOLOGY SPECIALISTS OF AUGUSTA
Street	7013 EVANS TOWN CENTER BOULEVARD SUITE 101
City	EVANS
State	GA
ZIP	30809
Phone	706 922-4545
CertificateType	4
CertificateEffectiveDate	4/28/2023
CertificateExpirationDate	4/27/2025
FacilityType	Waiver

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