11D1107426 CLIA NUMBER - PIEDMONT COMMUNITY IMAGING OF COLUMBUS

Laboratory Demographics

  • CLIA Code: 11D1107426
  • Facility Name: PIEDMONT COMMUNITY IMAGING OF COLUMBUS
  • Facility Address: 2040 10TH AVENUE
    COLUMBUS, GA
    ZIP 31901
  • Facility Phone: 706 322-3000
  • Facility Type: Other - OUT/P IMAGING CTR
  • Facility Type: Waiver
  • Lab Director: WILLIAM V. WAGSTAFF
  • NPI Number: 1316108624
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 11D1107426
LAB Type Other - OUT/P IMAGING CTR
Facility Name PIEDMONT COMMUNITY IMAGING OF COLUMBUS
Street 2040 10TH AVENUE
City COLUMBUS
State GA
ZIP 31901
Phone 706 322-3000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/5/2023
Certificate Expiration Date 11/4/2025
Facility Type Other - OUT/P IMAGING CTR
Lab Director WILLIAM V. WAGSTAFF

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