11D2153469 CLIA NUMBER - TSPC-GA, LLC DBA THRIVE SKILLED PEDIATRIC CARE

Laboratory Demographics

  • CLIA Code: 11D2153469
  • Facility Name: TSPC-GA, LLC DBA THRIVE SKILLED PEDIATRIC CARE
  • Facility Address: 2278 INGLESIDE AVENUE
    MACON, GA
    ZIP 31204
  • Facility Phone: 478 287-4165
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: SAMANTHA LUNDY
  • NPI Number: 1285111088
  • Taxonomy: 251J00000X - Nursing Care

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CLIA Record

Field Name Field Value
CLIA Number 11D2153469
LAB Type Home Health Agency
Facility Name TSPC-GA, LLC DBA THRIVE SKILLED PEDIATRIC CARE
Street 2278 INGLESIDE AVENUE
City MACON
State GA
ZIP 31204
Phone 478 287-4165
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/27/2024
Certificate Expiration Date 8/26/2026
Facility Type Home Health Agency
Lab Director SAMANTHA LUNDY

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