11D2108872 CLIA NUMBER - CRH FAMILY MEDICINE GROUP

Laboratory Demographics

  • CLIA Code: 11D2108872
  • Facility Name: CRH FAMILY MEDICINE GROUP
  • Facility Address: 100 DOCTORS DRIVE STE G
    DOUGLAS, GA
    ZIP 31533
  • Facility Phone: 912 384-6186
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: LYDIA TANNER
  • NPI Number: 1346591229
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2108872
LAB Type Physician Office
Facility Name CRH FAMILY MEDICINE GROUP
Street 100 DOCTORS DRIVE STE G
City DOUGLAS
State GA
ZIP 31533
Phone 912 384-6186
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/15/2024
Certificate Expiration Date 2/14/2026
Facility Type Physician Office
Lab Director LYDIA TANNER

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