11D2227465 CLIA NUMBER - CRISP FAMILY MEDICINE - ASHBURN

Laboratory Demographics

  • CLIA Code: 11D2227465
  • Facility Name: CRISP FAMILY MEDICINE - ASHBURN
  • Facility Address: 235 EAST WASHINGTON AVENUE
    ASHBURN, GA
    ZIP 31714
  • Facility Phone: 229 276-3320
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RONALD HUET
  • NPI Number: 1194305680
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2227465
LAB Type Physician Office
Facility Name CRISP FAMILY MEDICINE - ASHBURN
Street 235 EAST WASHINGTON AVENUE
City ASHBURN
State GA
ZIP 31714
Phone 229 276-3320
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/14/2025
Certificate Expiration Date 6/13/2027
Facility Type Physician Office
Lab Director RONALD HUET

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