11D2143519 CLIA NUMBER - MACON CBOC

Laboratory Demographics

  • CLIA Code: 11D2143519
  • Facility Name: MACON CBOC
  • Facility Address: 5566 THOMASTON ROAD
    MACON, GA
    ZIP 31220
  • Facility Phone: 478 272-1210
  • Facility Type: Community Clinic
  • Facility Type: Accreditation
  • Lab Director: AML R. GIRGIS
  • NPI Number: 1881133064
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2143519
LAB Type Community Clinic
Facility Name MACON CBOC
Street 5566 THOMASTON ROAD
City MACON
State GA
ZIP 31220
Phone 478 272-1210
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 1/31/2018
Certificate Expiration Date 5/22/2026
Facility Type Community Clinic
Lab Director AML R. GIRGIS

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