11D2188609 CLIA NUMBER - PREMIER CARE OMEGA

Laboratory Demographics

  • CLIA Code: 11D2188609
  • Facility Name: PREMIER CARE OMEGA
  • Facility Address: 130 MOORE STREET
    OMEGA, GA
    ZIP 31775
  • Facility Phone: 229 528-6500
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ROBERT C. BOWMAN
  • NPI Number: 1073140927
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2188609
LAB Type Physician Office
Facility Name PREMIER CARE OMEGA
Street 130 MOORE STREET
City OMEGA
State GA
ZIP 31775
Phone 229 528-6500
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 7/20/2024
Certificate Expiration Date 7/19/2026
Facility Type Physician Office
Lab Director ROBERT C. BOWMAN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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