11D2133086 CLIA NUMBER - QUADMED KOHL'S MACON

Laboratory Demographics

  • CLIA Code: 11D2133086
  • Facility Name: QUADMED KOHL'S MACON
  • Facility Address: 3030 AIRPORT E DRIVE
    MACON, GA
    ZIP 31216
  • Facility Phone: 478 785-6000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: COURTNEY YOUNG
  • NPI Number: 1649788191
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2133086
LAB Type Physician Office
Facility Name QUADMED KOHL'S MACON
Street 3030 AIRPORT E DRIVE
City MACON
State GA
ZIP 31216
Phone 478 785-6000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/6/2025
Certificate Expiration Date 7/5/2027
Facility Type Physician Office
Lab Director COURTNEY YOUNG

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