11D2204116 CLIA NUMBER - MED STOP FAMILY PRACTICE LLC

Laboratory Demographics

  • CLIA Code: 11D2204116
  • Facility Name: MED STOP FAMILY PRACTICE LLC
  • Facility Address: 106 WEST 2ND AVENUE
    SANDERSVILLE, GA
    ZIP 31082
  • Facility Phone: 478 412-2105
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PATTI L. MARAT
  • NPI Number: 1073123709
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2204116
LAB Type Physician Office
Facility Name MED STOP FAMILY PRACTICE LLC
Street 106 WEST 2ND AVENUE
City SANDERSVILLE
State GA
ZIP 31082
Phone 478 412-2105
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/8/2024
Certificate Expiration Date 12/7/2026
Facility Type Physician Office
Lab Director PATTI L. MARAT

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