11D2196567 CLIA NUMBER - FANNIN COUNTY FIRE/ EMS

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Laboratory Demographics

CLIA Number: 11D2196567

Facility Name: FANNIN COUNTY FIRE/ EMS

Facility Address:
20 STATION RIDGE
BLUE RIDGE, GA
ZIP 30513
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Facility Phone Number: 706 632-1958

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1801912597

Taxonomy: 3416L0300X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	11D2196567
LAB Type	Ambulance
Facility Name	FANNIN COUNTY FIRE/ EMS
Street	20 STATION RIDGE
City	BLUE RIDGE
State	GA
ZIP	30513
Phone	706 632-1958
CertificateType	4
CertificateEffectiveDate	10/19/2022
CertificateExpirationDate	10/18/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024