11D2153050 CLIA NUMBER - SOUTHERN CORRECTIONAL MEDICINE, LLC

Laboratory Demographics

  • CLIA Code: 11D2153050
  • Facility Name: SOUTHERN CORRECTIONAL MEDICINE, LLC
  • Facility Address: 225 HIGHWAY 24 SOUTH
    WAYNESBORO, GA
    ZIP 30830
  • Facility Phone: 912 283-5260
  • Facility Type: Other - JAIL MEDICAL UNIT
  • Facility Type: Waiver
  • Lab Director: PETER WROBEL
  • NPI Number: 1467620443
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 11D2153050
LAB Type Other - JAIL MEDICAL UNIT
Facility Name SOUTHERN CORRECTIONAL MEDICINE, LLC
Street 225 HIGHWAY 24 SOUTH
City WAYNESBORO
State GA
ZIP 30830
Phone 912 283-5260
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/22/2024
Certificate Expiration Date 8/21/2026
Facility Type Other - JAIL MEDICAL UNIT
Lab Director PETER WROBEL

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