11D2190390 CLIA NUMBER - IRWIN COUNTY DETENTION CENTER

Laboratory Demographics

  • CLIA Code: 11D2190390
  • Facility Name: IRWIN COUNTY DETENTION CENTER
  • Facility Address: 132 COTTON DRIVE
    OCILLA, GA
    ZIP 31774
  • Facility Phone: 229 468-4121
  • Facility Type: Prison
  • Facility Type: Waiver
  • Lab Director: HOWARD C. MCMAHAN
  • NPI Number: 1811397060
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 11D2190390
LAB Type Prison
Facility Name IRWIN COUNTY DETENTION CENTER
Street 132 COTTON DRIVE
City OCILLA
State GA
ZIP 31774
Phone 229 468-4121
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/13/2024
Certificate Expiration Date 8/12/2026
Facility Type Prison
Lab Director HOWARD C. MCMAHAN

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