11D2019414 CLIA NUMBER - EFFINGHAM HOSPITAL INC DBA EFFINGHAM FAMILY MEDICINE AT 21

Laboratory Demographics

  • CLIA Code: 11D2019414
  • Facility Name: EFFINGHAM HOSPITAL INC DBA EFFINGHAM FAMILY MEDICINE AT 21
  • Facility Address: 1451 GA HIGHWAY SOUTH, SUITE H
    SPRINGFIELD, GA
    ZIP 31329
  • Facility Phone: 912 754-1035
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JOHN R. BENNETT
  • NPI Number: 1245577048
  • Taxonomy: 207VF0040X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 11D2019414
LAB Type Physician Office
Facility Name EFFINGHAM HOSPITAL INC DBA EFFINGHAM FAMILY MEDICINE AT 21
Street 1451 GA HIGHWAY SOUTH, SUITE H
City SPRINGFIELD
State GA
ZIP 31329
Phone 912 754-1035
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 1/31/2025
Certificate Expiration Date 1/30/2027
Facility Type Physician Office
Lab Director JOHN R. BENNETT

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