11D2157328 CLIA NUMBER - UNISON BEHAVIORAL HEALTH (WARE CHILD & ADOLESCENT OUTPATIENT)

Laboratory Demographics

  • CLIA Code: 11D2157328
  • Facility Name: UNISON BEHAVIORAL HEALTH (WARE CHILD & ADOLESCENT OUTPATIENT)
  • Facility Address: 1003 MARY STREET
    WAYCROSS, GA
    ZIP 31503
  • Facility Phone: 912 449-7104
  • Facility Type: Other - OUTPATIENT MH&SA CLINIC
  • Facility Type: Waiver
  • Lab Director: TIFFANY J. HENDERSON
  • NPI Number: 1720124043
  • Taxonomy: 251C00000X - Day Training, Developmentally Disabled Services

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CLIA Record

Field Name Field Value
CLIA Number 11D2157328
LAB Type Other - OUTPATIENT MH&SA CLINIC
Facility Name UNISON BEHAVIORAL HEALTH (WARE CHILD & ADOLESCENT OUTPATIENT)
Street 1003 MARY STREET
City WAYCROSS
State GA
ZIP 31503
Phone 912 449-7104
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/5/2024
Certificate Expiration Date 11/4/2026
Facility Type Other - OUTPATIENT MH&SA CLINIC
Lab Director TIFFANY J. HENDERSON

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