11D2252212 CLIA NUMBER - SOUTHERN LUNG SPECIALIST PC

Laboratory Demographics

  • CLIA Code: 11D2252212
  • Facility Name: SOUTHERN LUNG SPECIALIST PC
  • Facility Address: 754 1ST STREET, SUITE 205
    MACON, GA
    ZIP 31201
  • Facility Phone: 478 745-9998
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GERALD T. TARIRAH
  • NPI Number: 1821440819
  • Taxonomy: 207RP1001X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2252212
LAB Type Physician Office
Facility Name SOUTHERN LUNG SPECIALIST PC
Street 754 1ST STREET, SUITE 205
City MACON
State GA
ZIP 31201
Phone 478 745-9998
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/9/2024
Certificate Expiration Date 2/8/2026
Facility Type Physician Office
Lab Director GERALD T. TARIRAH

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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