11D2214854 CLIA NUMBER - WAYNE SJC MEDICAL GROUP - OBGYN

Laboratory Demographics

CLIA Number: 11D2214854

Facility Name: WAYNE SJC MEDICAL GROUP - OBGYN

Facility Address:
228 MEMORIAL DRIVE
JESUP, GA
ZIP 31545
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Facility Phone Number: 912 559-2432

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1538421177

Taxonomy: 207Y00000X - Otolaryngology
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

CLIA Record

Field Name	Field Value
CLIA Number	11D2214854
LAB Type	Physician Office
Facility Name	WAYNE SJC MEDICAL GROUP - OBGYN
Street	228 MEMORIAL DRIVE
City	JESUP
State	GA
ZIP	31545
Phone	912 559-2432
CertificateType	3
CertificateEffectiveDate	2/25/2023
CertificateExpirationDate	2/24/2025
FacilityType	PPMP

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