11D2068055 CLIA NUMBER - SOUTH GEORGIA EYE PARTNERS

Laboratory Demographics

  • CLIA Code: 11D2068055
  • Facility Name: SOUTH GEORGIA EYE PARTNERS
  • Facility Address: 416 TIFT AVENUE N
    TIFTON, GA
    ZIP 31794
  • Facility Phone: 229 391-4180
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SCOTT H. PETERMANN
  • NPI Number: 1093077984
  • Taxonomy: 207W00000X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 11D2068055
LAB Type Physician Office
Facility Name SOUTH GEORGIA EYE PARTNERS
Street 416 TIFT AVENUE N
City TIFTON
State GA
ZIP 31794
Phone 229 391-4180
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2023
Certificate Expiration Date 10/27/2025
Facility Type Physician Office
Lab Director SCOTT H. PETERMANN

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