11D2068058 CLIA NUMBER - SOUTH GEORGIA EYE PARTNERS

Laboratory Demographics

  • CLIA Code: 11D2068058
  • Facility Name: SOUTH GEORGIA EYE PARTNERS
  • Facility Address: 200 DOCTORS DRIVE, SUITE 105
    DOUGLAS, GA
    ZIP 31533
  • Facility Phone: 912 384-1840
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SCOTT H. PETERMANN
  • NPI Number: 1124226055
  • Taxonomy: 207RH0003X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2068058
LAB Type Physician Office
Facility Name SOUTH GEORGIA EYE PARTNERS
Street 200 DOCTORS DRIVE, SUITE 105
City DOUGLAS
State GA
ZIP 31533
Phone 912 384-1840
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