11D2224662 CLIA NUMBER - CARECONNECT FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 11D2224662
  • Facility Name: CARECONNECT FAMILY PRACTICE
  • Facility Address: 112 W 6TH AVENUE, SUITE B
    BUENA VISTA, GA
    ZIP 31803
  • Facility Phone: 229 800-5488
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: BRIDGET MOSLEY
  • NPI Number: 1154891794
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2224662
LAB Type Federally Qualified Health Center
Facility Name CARECONNECT FAMILY PRACTICE
Street 112 W 6TH AVENUE, SUITE B
City BUENA VISTA
State GA
ZIP 31803
Phone 229 800-5488
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/14/2025
Certificate Expiration Date 5/13/2027
Facility Type Federally Qualified Health Center
Lab Director BRIDGET MOSLEY

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