11D2010159 CLIA NUMBER - MERCER MEDICINE, LLC

Laboratory Demographics

  • CLIA Code: 11D2010159
  • Facility Name: MERCER MEDICINE, LLC
  • Facility Address: 250 MARTIN LUTHER KING BLVD
    MACON, GA
    ZIP 31201
  • Facility Phone: 478 301-4111
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. EDWIN GRIMSLEY
  • NPI Number: 1053481036
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2010159
LAB Type Physician Office
Facility Name MERCER MEDICINE, LLC
Street 250 MARTIN LUTHER KING BLVD
City MACON
State GA
ZIP 31201
Phone 478 301-4111
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/1/2024
Certificate Expiration Date 4/30/2026
Facility Type Physician Office
Lab Director DR. EDWIN GRIMSLEY

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