11D2191876 CLIA NUMBER - GRADY PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 11D2191876
  • Facility Name: GRADY PRIMARY CARE
  • Facility Address: 235 1ST AVENUE, NE
    CAIRO, GA
    ZIP 39828
  • Facility Phone: 229 378-2214
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: KIMBERLY ANN HARBIN
  • NPI Number: 1477716769
  • Taxonomy: 261QH0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2191876
LAB Type Physician Office
Facility Name GRADY PRIMARY CARE
Street 235 1ST AVENUE, NE
City CAIRO
State GA
ZIP 39828
Phone 229 378-2214
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 9/2/2024
Certificate Expiration Date 9/1/2026
Facility Type Physician Office
Lab Director KIMBERLY ANN HARBIN

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