11D2165574 CLIA NUMBER - CLAYTON FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 11D2165574
  • Facility Name: CLAYTON FAMILY MEDICINE
  • Facility Address: 458 N MAIN STREET
    CLAYTON, GA
    ZIP 30525
  • Facility Phone: 706 960-9550
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BRIAN E. PRATT
  • NPI Number: 1194283002
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2165574
LAB Type Physician Office
Facility Name CLAYTON FAMILY MEDICINE
Street 458 N MAIN STREET
City CLAYTON
State GA
ZIP 30525
Phone 706 960-9550
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/1/2025
Certificate Expiration Date 4/30/2027
Facility Type Physician Office
Lab Director BRIAN E. PRATT

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