11D2246504 CLIA NUMBER - COVENANT PEDIATRICS

Laboratory Demographics

  • CLIA Code: 11D2246504
  • Facility Name: COVENANT PEDIATRICS
  • Facility Address: 229 ADDISON SQUARE
    EVANS, GA
    ZIP 30809
  • Facility Phone: 706 364-6045
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAVID FISHER
  • NPI Number: 1730310491
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2246504
LAB Type Physician Office
Facility Name COVENANT PEDIATRICS
Street 229 ADDISON SQUARE
City EVANS
State GA
ZIP 30809
Phone 706 364-6045
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/27/2023
Certificate Expiration Date 12/26/2025
Facility Type Physician Office
Lab Director DAVID FISHER

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