11D2081348 CLIA NUMBER - IRWIN SURGICAL MEDICAL-DOUGLAS

Laboratory Demographics

  • CLIA Code: 11D2081348
  • Facility Name: IRWIN SURGICAL MEDICAL-DOUGLAS
  • Facility Address: 2016 OCILLA ROAD
    DOUGLAS, GA
    ZIP 31533
  • Facility Phone: 912 384-4010
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARSHALL TANNER
  • NPI Number: 1023418928
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2081348
LAB Type Physician Office
Facility Name IRWIN SURGICAL MEDICAL-DOUGLAS
Street 2016 OCILLA ROAD
City DOUGLAS
State GA
ZIP 31533
Phone 912 384-4010
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 Physician Office
Lab Director MARSHALL TANNER

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