11D2200489 CLIA NUMBER - SOUTHERN CORRECTIONAL MEDICINE, LLC

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Laboratory Demographics

CLIA Number: 11D2200489

Facility Name: SOUTHERN CORRECTIONAL MEDICINE, LLC

Facility Address:
3487 HARRIS ROAD
WAYCROSS, GA
ZIP 31503
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Facility Phone Number: 912 283-5260

Facility Type: Other - JAIL

Certificate Type: Waiver

NPI Number: 1629731617

Taxonomy: 253Z00000X - In Home Supportive Care
An In Home Supportive Care Agency provides services in the patient's home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves.

CLIA Record

Field Name	Field Value
CLIA Number	11D2200489
LAB Type	Other - JAIL
Facility Name	SOUTHERN CORRECTIONAL MEDICINE, LLC
Street	3487 HARRIS ROAD
City	WAYCROSS
State	GA
ZIP	31503
Phone	912 283-5260
CertificateType	4
CertificateEffectiveDate	11/16/2022
CertificateExpirationDate	11/15/2024
FacilityType	Waiver

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