11D2186632 CLIA NUMBER - DR OWUSU PROFESSIONAL SERVICES DBA RENEW HEALTH CLINIC

Laboratory Demographics

  • CLIA Code: 11D2186632
  • Facility Name: DR OWUSU PROFESSIONAL SERVICES DBA RENEW HEALTH CLINIC
  • Facility Address: 2022 10TH AVENUE
    COLUMBUS, GA
    ZIP 31901
  • Facility Phone: 917 319-5411
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JACQUELINE A. OWUSU
  • NPI Number: 1376137844
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2186632
LAB Type Physician Office
Facility Name DR OWUSU PROFESSIONAL SERVICES DBA RENEW HEALTH CLINIC
Street 2022 10TH AVENUE
City COLUMBUS
State GA
ZIP 31901
Phone 917 319-5411
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/19/2024
Certificate Expiration Date 6/18/2026
Facility Type Physician Office
Lab Director JACQUELINE A. OWUSU

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