11D2033810 CLIA NUMBER - UPSON REGIONAL MED CENTER

Laboratory Demographics

  • CLIA Code: 11D2033810
  • Facility Name: UPSON REGIONAL MED CENTER
  • Facility Address: 100 HIGHWAY 18, SUITE 103
    SUNNY SIDE, GA
    ZIP 30284
  • Facility Phone: (706) 647-8111
  • Facility Type: Hospital
  • Facility Type: Waiver
  • Lab Director: MARIAN PENNINGTON
  • NPI Number: 1093796443
  • Taxonomy: 275N00000X - Medicare Defined Swing Bed Unit

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CLIA Record

Field Name Field Value
CLIA Number 11D2033810
LAB Type Hospital
Facility Name UPSON REGIONAL MED CENTER
Street 100 HIGHWAY 18, SUITE 103
City SUNNY SIDE
State GA
ZIP 30284
Phone 7066478111
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/12/2025
Certificate Expiration Date 12/11/2027
Facility Type Hospital
Lab Director MARIAN PENNINGTON

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This page was last updated on: 6/29/2026