11D2208616 CLIA NUMBER - GILMER COUNTY FIRE RESCUE

Laboratory Demographics

  • CLIA Code: 11D2208616
  • Facility Name: GILMER COUNTY FIRE RESCUE
  • Facility Address: 325 HOWARD SIMMONS ROAD
    ELLIJAY, GA
    ZIP 30540
  • Facility Phone: 706 635-1333
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: WILLIAM D. SERGENT
  • NPI Number: 1952502338
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 11D2208616
LAB Type Ambulance
Facility Name GILMER COUNTY FIRE RESCUE
Street 325 HOWARD SIMMONS ROAD
City ELLIJAY
State GA
ZIP 30540
Phone 706 635-1333
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/7/2025
Certificate Expiration Date 1/6/2027
Facility Type Ambulance
Lab Director WILLIAM D. SERGENT

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