11D2124084 CLIA NUMBER - AIR EVAC LIFETEAM

Laboratory Demographics

  • CLIA Code: 11D2124084
  • Facility Name: AIR EVAC LIFETEAM
  • Facility Address: 304 TIFTON ELDORADO
    TIFTON, GA
    ZIP 31794
  • Facility Phone: 229 386-5303
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: GREG DAMPIER
  • NPI Number: 1730622838
  • Taxonomy: 3416A0800X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 11D2124084
LAB Type Mobile Laboratory
Facility Name AIR EVAC LIFETEAM
Street 304 TIFTON ELDORADO
City TIFTON
State GA
ZIP 31794
Phone 229 386-5303
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/10/2025
Certificate Expiration Date 1/9/2027
Facility Type Mobile Laboratory
Lab Director GREG DAMPIER

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