11D2060927 CLIA NUMBER - MCKINNEY MEDICAL CENTER INC

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Laboratory Demographics

CLIA Number: 11D2060927

Facility Name: MCKINNEY MEDICAL CENTER INC

Facility Address:
935 MCDONALD STREET
WAYCROSS, GA
ZIP 31501
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Facility Phone Number: 912 285-5080

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1578822433

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D2060927
LAB Type	Federally Qualified Health Center
Facility Name	MCKINNEY MEDICAL CENTER INC
Street	935 MCDONALD STREET
City	WAYCROSS
State	GA
ZIP	31501
Phone	912 285-5080
CertificateType	4
CertificateEffectiveDate	6/20/2023
CertificateExpirationDate	6/19/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024