11D2081347 CLIA NUMBER - WILLACOOCHEE CLINIC

Laboratory Demographics

  • CLIA Code: 11D2081347
  • Facility Name: WILLACOOCHEE CLINIC
  • Facility Address: 134 FLEET AVENUE EAST
    WILLACOOCHEE, GA
    ZIP 31650
  • Facility Phone: 912 534-6103
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: ASHFAQ SAIYED
  • NPI Number: 1851446454
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2081347
LAB Type Rural Health Clinic
Facility Name WILLACOOCHEE CLINIC
Street 134 FLEET AVENUE EAST
City WILLACOOCHEE
State GA
ZIP 31650
Phone 912 534-6103
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/23/2024
Certificate Expiration Date 7/22/2026
Facility Type Rural Health Clinic
Lab Director ASHFAQ SAIYED

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