11D2133712 CLIA NUMBER - DIXIE MEDICAL, LLC

Laboratory Demographics

  • CLIA Code: 11D2133712
  • Facility Name: DIXIE MEDICAL, LLC
  • Facility Address: 1085 PLAZA AVENUE
    EASTMAN, GA
    ZIP 31023
  • Facility Phone: 478 559-1386
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TONYA YAWN-LEWIS
  • NPI Number: 1669909172
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2133712
LAB Type Physician Office
Facility Name DIXIE MEDICAL, LLC
Street 1085 PLAZA AVENUE
City EASTMAN
State GA
ZIP 31023
Phone 478 559-1386
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/19/2025
Certificate Expiration Date 7/18/2027
Facility Type Physician Office
Lab Director TONYA YAWN-LEWIS

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