11D2171238 CLIA NUMBER - TENNET, LLC DBA PRIME TIME PEDIATRICS

Laboratory Demographics

  • CLIA Code: 11D2171238
  • Facility Name: TENNET, LLC DBA PRIME TIME PEDIATRICS
  • Facility Address: 1618 MARS HILL ROAD, SUITE B
    WATKINSVILLE, GA
    ZIP 30677
  • Facility Phone: 706 705-4634
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAVID R. SPRAYBERRY
  • NPI Number: 1972149169
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D2171238
LAB Type Physician Office
Facility Name TENNET, LLC DBA PRIME TIME PEDIATRICS
Street 1618 MARS HILL ROAD, SUITE B
City WATKINSVILLE
State GA
ZIP 30677
Phone 706 705-4634
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/28/2025
Certificate Expiration Date 8/27/2027
Facility Type Physician Office
Lab Director DAVID R. SPRAYBERRY

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