11D2069394 CLIA NUMBER - CARECONNECT FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 11D2069394
  • Facility Name: CARECONNECT FAMILY PRACTICE
  • Facility Address: 80 WEST MAIN STREET
    BUTLER, GA
    ZIP 31006
  • Facility Phone: 478 862-5453
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: BRIDGET MOSLEY
  • NPI Number: 1104255934
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2069394
LAB Type Federally Qualified Health Center
Facility Name CARECONNECT FAMILY PRACTICE
Street 80 WEST MAIN STREET
City BUTLER
State GA
ZIP 31006
Phone 478 862-5453
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/25/2023
Certificate Expiration Date 11/24/2025
Facility Type Federally Qualified Health Center
Lab Director BRIDGET MOSLEY

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