11D2104467 CLIA NUMBER - CRH SCHOOL BASED HEALTH CLINIC

Laboratory Demographics

  • CLIA Code: 11D2104467
  • Facility Name: CRH SCHOOL BASED HEALTH CLINIC
  • Facility Address: 901 ROUTE 206
    DOUGLAS, GA
    ZIP 31533
  • Facility Phone: 912 384-1477
  • Facility Type: School/Student Health Service
  • Facility Type: Waiver
  • Lab Director: LISTER DEBRA
  • NPI Number: 1457722720
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2104467
LAB Type School/Student Health Service
Facility Name CRH SCHOOL BASED HEALTH CLINIC
Street 901 ROUTE 206
City DOUGLAS
State GA
ZIP 31533
Phone 912 384-1477
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/5/2023
Certificate Expiration Date 11/4/2025
Facility Type School/Student Health Service
Lab Director LISTER DEBRA

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