11D2122689 CLIA NUMBER - SOUTHEASTERN SURGERY&SLEEP APNEA TREATMENT CTR LLC LLC DBA SOUTHEASTERN IMMEDIATE CARE

Laboratory Demographics

  • CLIA Code: 11D2122689
  • Facility Name: SOUTHEASTERN SURGERY&SLEEP APNEA TREATMENT CTR LLC LLC DBA SOUTHEASTERN IMMEDIATE CARE
  • Facility Address: 1006-1 HILLCREST PARKWAY
    DUBLIN, GA
    ZIP 31021
  • Facility Phone: 855 811-6362
  • Facility Type: Other - IMMEDIATE CARE
  • Facility Type: Waiver
  • Lab Director: JOHN SOUZA
  • NPI Number: 1902935281
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 11D2122689
LAB Type Other - IMMEDIATE CARE
Facility Name SOUTHEASTERN SURGERY&SLEEP APNEA TREATMENT CTR LLC LLC DBA SOUTHEASTERN IMMEDIATE CARE
Street 1006-1 HILLCREST PARKWAY
City DUBLIN
State GA
ZIP 31021
Phone 855 811-6362
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/22/2024
Certificate Expiration Date 2/21/2026
Facility Type Other - IMMEDIATE CARE
Lab Director JOHN SOUZA

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