11D2189075 CLIA NUMBER - INTERVENTIONAL AND ALTERNATIVE SPINE AND WELLNESS

Laboratory Demographics

  • CLIA Code: 11D2189075
  • Facility Name: INTERVENTIONAL AND ALTERNATIVE SPINE AND WELLNESS
  • Facility Address: 3630 WHEELER RD
    AUGUSTA, GA
    ZIP 30909
  • Facility Phone: 248 766-9257
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAVID L. BAKER
  • NPI Number: 1700490091
  • Taxonomy: 2081P2900X - Physical Medicine & Rehabilitation

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CLIA Record

Field Name Field Value
CLIA Number 11D2189075
LAB Type Physician Office
Facility Name INTERVENTIONAL AND ALTERNATIVE SPINE AND WELLNESS
Street 3630 WHEELER RD
City AUGUSTA
State GA
ZIP 30909
Phone 248 766-9257
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/27/2024
Certificate Expiration Date 7/26/2026
Facility Type Physician Office
Lab Director DAVID L. BAKER

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