11D2041755 CLIA NUMBER - TATTNALL HOSPITAL COMPANY, LLC OPTIM MEDICAL CENTER - TATTNALL

Laboratory Demographics

  • CLIA Code: 11D2041755
  • Facility Name: TATTNALL HOSPITAL COMPANY, LLC OPTIM MEDICAL CENTER - TATTNALL
  • Facility Address: 257 SOUTH MAIN STREET
    REIDSVILLE, GA
    ZIP 30453
  • Facility Phone: 912 644-5368
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JOSEPH C. HAGARTY
  • NPI Number: 1679520217
  • Taxonomy: 207P00000X - Emergency Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2041755
LAB Type Physician Office
Facility Name TATTNALL HOSPITAL COMPANY, LLC OPTIM MEDICAL CENTER - TATTNALL
Street 257 SOUTH MAIN STREET
City REIDSVILLE
State GA
ZIP 30453
Phone 912 644-5368
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/30/2024
Certificate Expiration Date 5/29/2026
Facility Type Physician Office
Lab Director DR. JOSEPH C. HAGARTY

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