11D2237236 CLIA NUMBER - BUILD AND RESTORE, LLC

Laboratory Demographics

  • CLIA Code: 11D2237236
  • Facility Name: BUILD AND RESTORE, LLC
  • Facility Address: 2211 BARTOW STREET
    BRUNSWICK, GA
    ZIP 31520
  • Facility Phone: 850 210-2473
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: GWENDOLYN M. FLONNERY-ROBERTS
  • NPI Number: 1225616618
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 11D2237236
LAB Type Practitioner Other
Facility Name BUILD AND RESTORE, LLC
Street 2211 BARTOW STREET
City BRUNSWICK
State GA
ZIP 31520
Phone 850 210-2473
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/23/2025
Certificate Expiration Date 9/22/2027
Facility Type Practitioner Other
Lab Director GWENDOLYN M. FLONNERY-ROBERTS

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