11D2037108 CLIA NUMBER - BEVERLY B SANDERS MD LLC

Laboratory Demographics

  • CLIA Code: 11D2037108
  • Facility Name: BEVERLY B SANDERS MD LLC
  • Facility Address: 1760 BASS ROAD, SUITE 200B
    MACON, GA
    ZIP 31210
  • Facility Phone: 478 309-1294
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MR. EDWIN T. THARPE
  • NPI Number: 1376772640
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2037108
LAB Type Physician Office
Facility Name BEVERLY B SANDERS MD LLC
Street 1760 BASS ROAD, SUITE 200B
City MACON
State GA
ZIP 31210
Phone 478 309-1294
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/21/2024
Certificate Expiration Date 2/20/2026
Facility Type Physician Office
Lab Director MR. EDWIN T. THARPE

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