11D2255814 CLIA NUMBER - KIRK CONSTANT CARE, LLC

Laboratory Demographics

  • CLIA Code: 11D2255814
  • Facility Name: KIRK CONSTANT CARE, LLC
  • Facility Address: 8 LAUREL COURT
    MOULTRIE, GA
    ZIP 31768
  • Facility Phone: 229 891-9016
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STEPHANIE WITHROW
  • NPI Number: 1699423889
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2255814
LAB Type Physician Office
Facility Name KIRK CONSTANT CARE, LLC
Street 8 LAUREL COURT
City MOULTRIE
State GA
ZIP 31768
Phone 229 891-9016
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/17/2024
Certificate Expiration Date 3/16/2026
Facility Type Physician Office
Lab Director STEPHANIE WITHROW

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