11D2034066 CLIA NUMBER - MOULTRIE CENTER OF WOMEN'S HEALTH

Laboratory Demographics

  • CLIA Code: 11D2034066
  • Facility Name: MOULTRIE CENTER OF WOMEN'S HEALTH
  • Facility Address: 1 MAGNOLIA COURT
    MOULTRIE, GA
    ZIP 31768
  • Facility Phone: 229 985-2198
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MOLLY JACOBS
  • NPI Number: 1821382672
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 11D2034066
LAB Type Physician Office
Facility Name MOULTRIE CENTER OF WOMEN'S HEALTH
Street 1 MAGNOLIA COURT
City MOULTRIE
State GA
ZIP 31768
Phone 229 985-2198
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/15/2023
Certificate Expiration Date 12/14/2025
Facility Type Physician Office
Lab Director MOLLY JACOBS

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