11D2015830 CLIA NUMBER - AIR EVAC EMS INC, AE 96

Laboratory Demographics

  • CLIA Code: 11D2015830
  • Facility Name: AIR EVAC EMS INC, AE 96
  • Facility Address: 148 PEACH TREE STREET
    JESUP, GA
    ZIP 31545
  • Facility Phone: 912 530-7522
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: DON MIXON
  • NPI Number: 1205144425
  • Taxonomy: 3416A0800X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 11D2015830
LAB Type Ambulance
Facility Name AIR EVAC EMS INC, AE 96
Street 148 PEACH TREE STREET
City JESUP
State GA
ZIP 31545
Phone 912 530-7522
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/5/2024
Certificate Expiration Date 11/4/2026
Facility Type Ambulance
Lab Director DON MIXON

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