11D2162372 CLIA NUMBER - MED-LAKE LABORATORIES

Laboratory Demographics

  • CLIA Code: 11D2162372
  • Facility Name: MED-LAKE LABORATORIES
  • Facility Address: 100 INDUSTRIAL PARK DRIVE
    MILLEDGEVILLE, GA
    ZIP 31061
  • Facility Phone: 478 414-4235
  • Facility Type: Independent
  • Facility Type: Accreditation
  • Lab Director: DR. ALVIN B. BRYAN JR
  • NPI Number: 1174092548
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 11D2162372
LAB Type Independent
Facility Name MED-LAKE LABORATORIES
Street 100 INDUSTRIAL PARK DRIVE
City MILLEDGEVILLE
State GA
ZIP 31061
Phone 478 414-4235
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 6/30/2025
Certificate Expiration Date 6/29/2027
Facility Type Independent
Lab Director DR. ALVIN B. BRYAN JR

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