11D2123869 CLIA NUMBER - PHOENIX HEALTH CENTER WTRS RESIDENTIAL

Laboratory Demographics

  • CLIA Code: 11D2123869
  • Facility Name: PHOENIX HEALTH CENTER WTRS RESIDENTIAL
  • Facility Address: 127 SOUTH SIXTH STREET
    WARNER ROBINS, GA
    ZIP 31088
  • Facility Phone: 478 988-1002
  • Facility Type: Other - DBHDD CSB
  • Facility Type: Waiver
  • Lab Director: MOLLY K. BOZEMAN
  • NPI Number: 1518435676
  • Taxonomy: 251B00000X - Case Management

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CLIA Record

Field Name Field Value
CLIA Number 11D2123869
LAB Type Other - DBHDD CSB
Facility Name PHOENIX HEALTH CENTER WTRS RESIDENTIAL
Street 127 SOUTH SIXTH STREET
City WARNER ROBINS
State GA
ZIP 31088
Phone 478 988-1002
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/5/2025
Certificate Expiration Date 1/4/2027
Facility Type Other - DBHDD CSB
Lab Director MOLLY K. BOZEMAN

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