11D2113489 CLIA NUMBER - HOTZ-SCOGGINS FAMILY MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 11D2113489
  • Facility Name: HOTZ-SCOGGINS FAMILY MEDICAL CENTER
  • Facility Address: 401 S MADISON STREET
    ALBANY, GA
    ZIP 31701
  • Facility Phone: 229 405-6960
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: DANIEL S. ROBERSON
  • NPI Number: 1033579412
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2113489
LAB Type Federally Qualified Health Center
Facility Name HOTZ-SCOGGINS FAMILY MEDICAL CENTER
Street 401 S MADISON STREET
City ALBANY
State GA
ZIP 31701
Phone 229 405-6960
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 5/24/2024
Certificate Expiration Date 5/23/2026
Facility Type Federally Qualified Health Center
Lab Director DANIEL S. ROBERSON

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