11D2159234 CLIA NUMBER - DMC PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 11D2159234
  • Facility Name: DMC PRIMARY CARE
  • Facility Address: 246 BENJAMIN H HILL DRIVE SW
    FITZGERALD, GA
    ZIP 31750
  • Facility Phone: 229 409-0874
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT A. LUDWICK
  • NPI Number: 1619541018
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2159234
LAB Type Physician Office
Facility Name DMC PRIMARY CARE
Street 246 BENJAMIN H HILL DRIVE SW
City FITZGERALD
State GA
ZIP 31750
Phone 229 409-0874
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/14/2024
Certificate Expiration Date 12/13/2026
Facility Type Physician Office
Lab Director ROBERT A. LUDWICK

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