11D2199373 CLIA NUMBER - APPLING COUNTY AMBULANCE SERVICE

Laboratory Demographics

  • CLIA Code: 11D2199373
  • Facility Name: APPLING COUNTY AMBULANCE SERVICE
  • Facility Address: 471 FAIR STREET
    BAXLEY, GA
    ZIP 31513
  • Facility Phone: 912 367-9841
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: TONYA F. FORDHAM
  • NPI Number: 1780644617
  • Taxonomy: 341600000X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 11D2199373
LAB Type Ambulance
Facility Name APPLING COUNTY AMBULANCE SERVICE
Street 471 FAIR STREET
City BAXLEY
State GA
ZIP 31513
Phone 912 367-9841
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/8/2024
Certificate Expiration Date 11/7/2026
Facility Type Ambulance
Lab Director TONYA F. FORDHAM

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