11D2202965 CLIA NUMBER - GEORGIA LINA EMS

Laboratory Demographics

  • CLIA Code: 11D2202965
  • Facility Name: GEORGIA LINA EMS
  • Facility Address: 1109 MEDICAL CENTER DRIVE, SUITE 4
    AUGUSTA, GA
    ZIP 30909
  • Facility Phone: 803 634-3215
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: STEVEN VINCENT
  • NPI Number: 1679286934
  • Taxonomy: 225100000X - Physical Therapist

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CLIA Record

Field Name Field Value
CLIA Number 11D2202965
LAB Type Ambulance
Facility Name GEORGIA LINA EMS
Street 1109 MEDICAL CENTER DRIVE, SUITE 4
City AUGUSTA
State GA
ZIP 30909
Phone 803 634-3215
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/2/2024
Certificate Expiration Date 12/1/2026
Facility Type Ambulance
Lab Director STEVEN VINCENT

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