11D1099262 CLIA NUMBER - AIRPORT CLINIC INCORPORATED

Laboratory Demographics

  • CLIA Code: 11D1099262
  • Facility Name: AIRPORT CLINIC INCORPORATED
  • Facility Address: 704 GIL HARBIN INDUSTRIAL BOULEVARD
    VALDOSTA, GA
    ZIP 31601
  • Facility Phone: 229 242-9003
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TRAVIS S. GRAHAM
  • NPI Number: 1730354739
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D1099262
LAB Type Physician Office
Facility Name AIRPORT CLINIC INCORPORATED
Street 704 GIL HARBIN INDUSTRIAL BOULEVARD
City VALDOSTA
State GA
ZIP 31601
Phone 229 242-9003
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/11/2025
Certificate Expiration Date 5/10/2027
Facility Type Physician Office
Lab Director TRAVIS S. GRAHAM

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