11D2161000 CLIA NUMBER - MIDTOWN OB GYN NORTH

Laboratory Demographics

  • CLIA Code: 11D2161000
  • Facility Name: MIDTOWN OB GYN NORTH
  • Facility Address: 3081 WILLIAMS ROAD, UNIT A
    COLUMBUS, GA
    ZIP 31909
  • Facility Phone: 706 320-2547
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SERENA D. TIDWELL
  • NPI Number: 1689759581
  • Taxonomy: 305S00000X - Point of Service

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CLIA Record

Field Name Field Value
CLIA Number 11D2161000
LAB Type Physician Office
Facility Name MIDTOWN OB GYN NORTH
Street 3081 WILLIAMS ROAD, UNIT A
City COLUMBUS
State GA
ZIP 31909
Phone 706 320-2547
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/26/2025
Certificate Expiration Date 1/25/2027
Facility Type Physician Office
Lab Director SERENA D. TIDWELL

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