11D2197432 CLIA NUMBER - ELBERT COUNTY EMERGENCY SERVICES

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Laboratory Demographics

CLIA Number: 11D2197432

Facility Name: ELBERT COUNTY EMERGENCY SERVICES

Facility Address:
112 MAHONEY DRIVE
ELBERTON, GA
ZIP 30635
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Facility Phone Number: 706 283-2003

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1477542983

Taxonomy: 3416L0300X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	11D2197432
LAB Type	Ambulance
Facility Name	ELBERT COUNTY EMERGENCY SERVICES
Street	112 MAHONEY DRIVE
City	ELBERTON
State	GA
ZIP	30635
Phone	706 283-2003
CertificateType	4
CertificateEffectiveDate	10/25/2022
CertificateExpirationDate	10/24/2024
FacilityType	Waiver

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