11D2258769 CLIA NUMBER - CRANDALL M CHAMBERS MD LLC

Laboratory Demographics

CLIA Number: 11D2258769

Facility Name: CRANDALL M CHAMBERS MD LLC

Facility Address:
811 22ND STREET
COLUMBUS, GA
ZIP 31904
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Facility Phone Number: 706 323-1054

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1396953790

Taxonomy: 207VX0000X - Obstetrics & Gynecology
A physician who specializes in diagnosis, treatment, and management of patients with obstetric conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	11D2258769
LAB Type	Physician Office
Facility Name	CRANDALL M CHAMBERS MD LLC
Street	811 22ND STREET
City	COLUMBUS
State	GA
ZIP	31904
Phone	706 323-1054
CertificateType	4
CertificateEffectiveDate	4/27/2024
CertificateExpirationDate	4/26/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024