11D2074713 CLIA NUMBER - ACCORDIA HEALTHCARE, LLC

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Laboratory Demographics

CLIA Number: 11D2074713

Facility Name: ACCORDIA HEALTHCARE, LLC

Facility Address:
3193 EAST FIRST ST
VIDALIA, GA
ZIP 30474
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Facility Phone Number: 912 537-8588

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1962826511

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D2074713
LAB Type	Physician Office
Facility Name	ACCORDIA HEALTHCARE, LLC
Street	3193 EAST FIRST ST
City	VIDALIA
State	GA
ZIP	30474
Phone	912 537-8588
CertificateType	2
CertificateEffectiveDate	5/6/2023
CertificateExpirationDate	5/5/2025
FacilityType	Compliance

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