11D2119545 CLIA NUMBER - C & C MEDICAL GROUP, INC

Laboratory Demographics

  • CLIA Code: 11D2119545
  • Facility Name: C & C MEDICAL GROUP, INC
  • Facility Address: 1384 BATTLEFIELD PARKWAY
    FORT OGLETHORPE, GA
    ZIP 30742
  • Facility Phone: 706 861-2700
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAYLE C. HAWTHORNE
  • NPI Number: 1871649525
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 11D2119545
LAB Type Physician Office
Facility Name C & C MEDICAL GROUP, INC
Street 1384 BATTLEFIELD PARKWAY
City FORT OGLETHORPE
State GA
ZIP 30742
Phone 706 861-2700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/29/2024
Certificate Expiration Date 9/28/2026
Facility Type Physician Office
Lab Director DAYLE C. HAWTHORNE

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