11D2201610 CLIA NUMBER - SHELNUTT GYNECOLOGY

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Laboratory Demographics

CLIA Number: 11D2201610

Facility Name: SHELNUTT GYNECOLOGY

Facility Address:
1500 OGLETHORPE AVENUE SUITE 200B
ATHENS, GA
ZIP 30606
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Facility Phone Number: 706 227-1164

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1952686248

Taxonomy: 207V00000X - Obstetrics & Gynecology
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

CLIA Record

Field Name	Field Value
CLIA Number	11D2201610
LAB Type	Physician Office
Facility Name	SHELNUTT GYNECOLOGY
Street	1500 OGLETHORPE AVENUE SUITE 200B
City	ATHENS
State	GA
ZIP	30606
Phone	706 227-1164
CertificateType	4
CertificateEffectiveDate	11/23/2022
CertificateExpirationDate	11/22/2024
FacilityType	Waiver

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