11D2175482 CLIA NUMBER - SMITH CLINIC, LLC

Laboratory Demographics

  • CLIA Code: 11D2175482
  • Facility Name: SMITH CLINIC, LLC
  • Facility Address: 5116 NORTHWIND BLVD
    VALDOSTA, GA
    ZIP 31605
  • Facility Phone: 229 261-9500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LARRY E. SMITH
  • NPI Number: 1780241505
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2175482
LAB Type Physician Office
Facility Name SMITH CLINIC, LLC
Street 5116 NORTHWIND BLVD
City VALDOSTA
State GA
ZIP 31605
Phone 229 261-9500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/21/2023
Certificate Expiration Date 11/20/2025
Facility Type Physician Office
Lab Director LARRY E. SMITH

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