11D2029438 CLIA NUMBER - AUGUSTA ENT

Laboratory Demographics

  • CLIA Code: 11D2029438
  • Facility Name: AUGUSTA ENT
  • Facility Address: 720 ST SEBASTIAN WAY, SUITE 201
    AUGUSTA, GA
    ZIP 30901
  • Facility Phone: 706 868-5676
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAMES F. KIMBROUGH
  • NPI Number: 1770649204
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 11D2029438
LAB Type Physician Office
Facility Name AUGUSTA ENT
Street 720 ST SEBASTIAN WAY, SUITE 201
City AUGUSTA
State GA
ZIP 30901
Phone 706 868-5676
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/1/2025
Certificate Expiration Date 2/28/2027
Facility Type Physician Office
Lab Director JAMES F. KIMBROUGH

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