11D2025783 CLIA NUMBER - LIGHTHOUSE CARE CENTER OF AUGUSTA

Laboratory Demographics

  • CLIA Code: 11D2025783
  • Facility Name: LIGHTHOUSE CARE CENTER OF AUGUSTA
  • Facility Address: 3100 PERIMETER PARKWAY
    AUGUSTA, GA
    ZIP 30909
  • Facility Phone: 706 651-0005
  • Facility Type: Other - PSYCH INPATIENT RESIDENT
  • Facility Type: Waiver
  • Lab Director: ANDRENE MURDOCK
  • NPI Number: 1437679412
  • Taxonomy: 323P00000X - Psychiatric Residential Treatment Facility

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CLIA Record

Field Name Field Value
CLIA Number 11D2025783
LAB Type Other - PSYCH INPATIENT RESIDENT
Facility Name LIGHTHOUSE CARE CENTER OF AUGUSTA
Street 3100 PERIMETER PARKWAY
City AUGUSTA
State GA
ZIP 30909
Phone 706 651-0005
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/16/2025
Certificate Expiration Date 6/15/2027
Facility Type Other - PSYCH INPATIENT RESIDENT
Lab Director ANDRENE MURDOCK

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