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11D2171540 CLIA NUMBER - KJH MEDICAL SERVICES DBA SHELLMAN MEDICAL

Laboratory Demographics

CLIA Number: 11D2171540

Facility Name: KJH MEDICAL SERVICES DBA SHELLMAN MEDICAL

Facility Address:
67 W RAILROAD STREET
SHELLMAN, GA
ZIP 39886
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Facility Phone Number: 229 679-2100

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1912481482

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name Field Value
CLIA Number 11D2171540
LAB Type Physician Office
Facility Name KJH MEDICAL SERVICES DBA SHELLMAN MEDICAL
Street 67 W RAILROAD STREET
City SHELLMAN
State GA
ZIP 39886
Phone 229 679-2100
CertificateType 4
CertificateEffectiveDate 9/4/2023
CertificateExpirationDate 9/3/2025
FacilityType Waiver

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