11D2199005 CLIA NUMBER - KACZOR ENTERPRISES, INC DBA U S AMBULANCE EMS

Laboratory Demographics

  • CLIA Code: 11D2199005
  • Facility Name: KACZOR ENTERPRISES, INC DBA U S AMBULANCE EMS
  • Facility Address: 200 GIMZO LANE
    DOUGLAS, GA
    ZIP 31535
  • Facility Phone: 912 592-3643
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: JOHN R. KEANON
  • NPI Number: 1194140103
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 11D2199005
LAB Type Ambulance
Facility Name KACZOR ENTERPRISES, INC DBA U S AMBULANCE EMS
Street 200 GIMZO LANE
City DOUGLAS
State GA
ZIP 31535
Phone 912 592-3643
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/5/2024
Certificate Expiration Date 11/4/2026
Facility Type Ambulance
Lab Director JOHN R. KEANON

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