11D1107421 CLIA NUMBER - RINCON MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 11D1107421
  • Facility Name: RINCON MEDICAL CENTER
  • Facility Address: 119 CHIMNEY ROAD
    RINCON, GA
    ZIP 31326
  • Facility Phone: 912 295-5560
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. SLAVKO KUKUCHA
  • NPI Number: 1548596737
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D1107421
LAB Type Physician Office
Facility Name RINCON MEDICAL CENTER
Street 119 CHIMNEY ROAD
City RINCON
State GA
ZIP 31326
Phone 912 295-5560
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/22/2024
Certificate Expiration Date 10/21/2026
Facility Type Physician Office
Lab Director DR. SLAVKO KUKUCHA

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