11D2189491 CLIA NUMBER - SUMTER PEDIATRICS LLC

Laboratory Demographics

  • CLIA Code: 11D2189491
  • Facility Name: SUMTER PEDIATRICS LLC
  • Facility Address: 151 GA HIGHWAY 27 E
    AMERICUS, GA
    ZIP 31709
  • Facility Phone: 229 924-8082
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NELSON T. MADRAZO
  • NPI Number: 1760534770
  • Taxonomy: 363LP0200X - Nurse Practitioner

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2189491
LAB Type Physician Office
Facility Name SUMTER PEDIATRICS LLC
Street 151 GA HIGHWAY 27 E
City AMERICUS
State GA
ZIP 31709
Phone 229 924-8082
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/31/2024
Certificate Expiration Date 7/30/2026
Facility Type Physician Office
Lab Director NELSON T. MADRAZO

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