11D2193208 CLIA NUMBER - FIRST CHOICE PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 11D2193208
  • Facility Name: FIRST CHOICE PRIMARY CARE
  • Facility Address: 400 POPLAR STREET
    MACON, GA
    ZIP 31201
  • Facility Phone: 478 787-4266
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: DR. TIMOTHY GRAVES
  • NPI Number: 1740666767
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2193208
LAB Type Federally Qualified Health Center
Facility Name FIRST CHOICE PRIMARY CARE
Street 400 POPLAR STREET
City MACON
State GA
ZIP 31201
Phone 478 787-4266
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/18/2024
Certificate Expiration Date 9/17/2026
Facility Type Federally Qualified Health Center
Lab Director DR. TIMOTHY GRAVES

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