11D2138883 CLIA NUMBER - CRH ONCOLOGY GROUP

Laboratory Demographics

CLIA Number: 11D2138883

Facility Name: CRH ONCOLOGY GROUP

Facility Address:
903 B WEST WARD STREET
DOUGLAS, GA
ZIP 31533
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Facility Phone Number: 912 384-1477

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1366784134

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D2138883
LAB Type	Physician Office
Facility Name	CRH ONCOLOGY GROUP
Street	903 B WEST WARD STREET
City	DOUGLAS
State	GA
ZIP	31533
Phone	912 384-1477
CertificateType	4
CertificateEffectiveDate	10/26/2023
CertificateExpirationDate	10/25/2025
FacilityType	Waiver

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