11D2159864 CLIA NUMBER - AIR EVAC EMS INC DBA AIR EVAC LIFETEAM EWL 154

Laboratory Demographics

  • CLIA Code: 11D2159864
  • Facility Name: AIR EVAC EMS INC DBA AIR EVAC LIFETEAM EWL 154
  • Facility Address: 1116 MORNINGSIDE DRIVE
    PERRY, GA
    ZIP 31069
  • Facility Phone: 478 542-4504
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: CHRISTOPHER POOLE
  • NPI Number: 1912472796
  • Taxonomy: 3416A0800X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 11D2159864
LAB Type Mobile Laboratory
Facility Name AIR EVAC EMS INC DBA AIR EVAC LIFETEAM EWL 154
Street 1116 MORNINGSIDE DRIVE
City PERRY
State GA
ZIP 31069
Phone 478 542-4504
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/28/2024
Certificate Expiration Date 12/27/2026
Facility Type Mobile Laboratory
Lab Director CHRISTOPHER POOLE

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