11D2032986 CLIA NUMBER - INTERNAL MEDICINE ASSOCIATES OF EAST GEORGIA

Laboratory Demographics

  • CLIA Code: 11D2032986
  • Facility Name: INTERNAL MEDICINE ASSOCIATES OF EAST GEORGIA
  • Facility Address: 1449 BRAMPTON AVENUE
    STATESBORO, GA
    ZIP 30458
  • Facility Phone: 912 681-7111
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BRIAN A. MOOGERFELD
  • NPI Number: 1508914367
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2032986
LAB Type Physician Office
Facility Name INTERNAL MEDICINE ASSOCIATES OF EAST GEORGIA
Street 1449 BRAMPTON AVENUE
City STATESBORO
State GA
ZIP 30458
Phone 912 681-7111
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/21/2023
Certificate Expiration Date 11/20/2025
Facility Type Physician Office
Lab Director BRIAN A. MOOGERFELD

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This page was last updated on: 3/20/2025