11D2003339 CLIA NUMBER - CHARLES B WEBSTER DETENTION CENTER

Laboratory Demographics

  • CLIA Code: 11D2003339
  • Facility Name: CHARLES B WEBSTER DETENTION CENTER
  • Facility Address: 1941 PHINIZY ROAD
    AUGUSTA, GA
    ZIP 30906
  • Facility Phone: 706 821-1101
  • Facility Type: Other - JAIL
  • Facility Type: Waiver
  • Lab Director: AYODELE AYEDUN
  • NPI Number: 1861653933
  • Taxonomy: 235Z00000X - Speech-Language Pathologist

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CLIA Record

Field Name Field Value
CLIA Number 11D2003339
LAB Type Other - JAIL
Facility Name CHARLES B WEBSTER DETENTION CENTER
Street 1941 PHINIZY ROAD
City AUGUSTA
State GA
ZIP 30906
Phone 706 821-1101
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/8/2024
Certificate Expiration Date 2/7/2026
Facility Type Other - JAIL
Lab Director AYODELE AYEDUN

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