11D2099846 CLIA NUMBER - MID-GEORGIA TOTAL CARE

Laboratory Demographics

  • CLIA Code: 11D2099846
  • Facility Name: MID-GEORGIA TOTAL CARE
  • Facility Address: 1111 GRIFFIN AVE, SUITE 1B
    EASTMAN, GA
    ZIP 31023
  • Facility Phone: 478 374-8998
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BLAKE MILNER
  • NPI Number: 1003200015
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2099846
LAB Type Physician Office
Facility Name MID-GEORGIA TOTAL CARE
Street 1111 GRIFFIN AVE, SUITE 1B
City EASTMAN
State GA
ZIP 31023
Phone 478 374-8998
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/4/2025
Certificate Expiration Date 8/3/2027
Facility Type Physician Office
Lab Director BLAKE MILNER

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