11D2120547 CLIA NUMBER - LIFE POINT MEDICAL, LLC

Laboratory Demographics

  • CLIA Code: 11D2120547
  • Facility Name: LIFE POINT MEDICAL, LLC
  • Facility Address: 189 BO JAMES STREET, SUITE 105
    CLAYTON, GA
    ZIP 30525
  • Facility Phone: 706 782-0016
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TIMOTHY S. BECK
  • NPI Number: 1154870533
  • Taxonomy: 261QM2500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2120547
LAB Type Physician Office
Facility Name LIFE POINT MEDICAL, LLC
Street 189 BO JAMES STREET, SUITE 105
City CLAYTON
State GA
ZIP 30525
Phone 706 782-0016
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/19/2024
Certificate Expiration Date 10/18/2026
Facility Type Physician Office
Lab Director TIMOTHY S. BECK

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