11D2108686 CLIA NUMBER - CCSG, INC

Laboratory Demographics

  • CLIA Code: 11D2108686
  • Facility Name: CCSG, INC
  • Facility Address: 116 MIMOSA DRIVE
    THOMASVILLE, GA
    ZIP 31792
  • Facility Phone: 229 551-0083
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GAINOUS JOY
  • NPI Number: 1295120145
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2108686
LAB Type Physician Office
Facility Name CCSG, INC
Street 116 MIMOSA DRIVE
City THOMASVILLE
State GA
ZIP 31792
Phone 229 551-0083
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/9/2024
Certificate Expiration Date 2/8/2026
Facility Type Physician Office
Lab Director GAINOUS JOY

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