11D2171780 CLIA NUMBER - SOUTHERN PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 11D2171780
  • Facility Name: SOUTHERN PRIMARY CARE
  • Facility Address: 101 WILLIE LEE PARKWAY, SUITE 400
    WARNER ROBINS, GA
    ZIP 31088
  • Facility Phone: 478 477-0966
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: JAYESH PATEL
  • NPI Number: 1386097848
  • Taxonomy: 106H00000X - Marriage & Family Therapist

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CLIA Record

Field Name Field Value
CLIA Number 11D2171780
LAB Type Physician Office
Facility Name SOUTHERN PRIMARY CARE
Street 101 WILLIE LEE PARKWAY, SUITE 400
City WARNER ROBINS
State GA
ZIP 31088
Phone 478 477-0966
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 3/1/2025
Certificate Expiration Date 2/28/2027
Facility Type Physician Office
Lab Director JAYESH PATEL

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