11D2131562 CLIA NUMBER - CARECONNECT CONVENIENT CARE

Laboratory Demographics

CLIA Number: 11D2131562

Facility Name: CARECONNECT CONVENIENT CARE

Facility Address:
125 MCDONALD AVENUE
CUTHBERT, GA
ZIP 39840
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Facility Phone Number: 229 732-3721

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1275060212

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D2131562
LAB Type	Federally Qualified Health Center
Facility Name	CARECONNECT CONVENIENT CARE
Street	125 MCDONALD AVENUE
City	CUTHBERT
State	GA
ZIP	39840
Phone	229 732-3721
CertificateType	4
CertificateEffectiveDate	6/1/2023
CertificateExpirationDate	5/31/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024