11D2016424 CLIA NUMBER - AIR EVAC EMS INC - AE 91

Laboratory Demographics

  • CLIA Code: 11D2016424
  • Facility Name: AIR EVAC EMS INC - AE 91
  • Facility Address: 2801 NORTH STREET, EAST
    VIDALIA, GA
    ZIP 30474
  • Facility Phone: 912 537-6875
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: RAFE WATERS
  • NPI Number: 1992028864
  • Taxonomy: 3416A0800X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 11D2016424
LAB Type Ambulance
Facility Name AIR EVAC EMS INC - AE 91
Street 2801 NORTH STREET, EAST
City VIDALIA
State GA
ZIP 30474
Phone 912 537-6875
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/18/2024
Certificate Expiration Date 11/17/2026
Facility Type Ambulance
Lab Director RAFE WATERS

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