11D2167152 CLIA NUMBER - BRUNSWICK URGENT CARE

Laboratory Demographics

CLIA Number: 11D2167152

Facility Name: BRUNSWICK URGENT CARE

Facility Address:
208 SCRANTON CONNECTOR, SUITE 117
BRUNSWICK, GA
ZIP 31525
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Facility Phone Number: 912 574-5958

Facility Type: Other - URGENT CARE

Certificate Type: Waiver

NPI Number: 1023571411

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	11D2167152
LAB Type	Other - URGENT CARE
Facility Name	BRUNSWICK URGENT CARE
Street	208 SCRANTON CONNECTOR, SUITE 117
City	BRUNSWICK
State	GA
ZIP	31525
Phone	912 574-5958
CertificateType	4
CertificateEffectiveDate	6/4/2023
CertificateExpirationDate	6/3/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024