11D1098863 CLIA NUMBER - DONALD A SELPH JUNIOR MD FACP PC

Laboratory Demographics

  • CLIA Code: 11D1098863
  • Facility Name: DONALD A SELPH JUNIOR MD FACP PC
  • Facility Address: 911 PLAZA AVENUE SUITE D
    EASTMAN, GA
    ZIP 31023
  • Facility Phone: (478) 374-5544
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DONALD A. SELPH JUNOR
  • NPI Number: 1427163344
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D1098863
LAB Type Physician Office
Facility Name DONALD A SELPH JUNIOR MD FACP PC
Street 911 PLAZA AVENUE SUITE D
City EASTMAN
State GA
ZIP 31023
Phone 4783745544
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/29/2025
Certificate Expiration Date 4/28/2027
Facility Type Physician Office
Lab Director DONALD A. SELPH JUNOR

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This page was last updated on: 5/18/2026