11D2130753 CLIA NUMBER - AIR EVAC LIFETEAM

Laboratory Demographics

  • CLIA Code: 11D2130753
  • Facility Name: AIR EVAC LIFETEAM
  • Facility Address: 216 AIRPORT ROAD, NE #W4
    MILLEDGEVILLE, GA
    ZIP 31061
  • Facility Phone: 478 234-5564
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: JERRY MCCREADY
  • NPI Number: 1184162943
  • Taxonomy: 3416A0800X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 11D2130753
LAB Type Mobile Laboratory
Facility Name AIR EVAC LIFETEAM
Street 216 AIRPORT ROAD, NE #W4
City MILLEDGEVILLE
State GA
ZIP 31061
Phone 478 234-5564
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/17/2025
Certificate Expiration Date 5/16/2027
Facility Type Mobile Laboratory
Lab Director JERRY MCCREADY

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