11D2259240 CLIA NUMBER - GEORGIA DIAGNOSTIC CLASSIFICATION PRISON

Laboratory Demographics

  • CLIA Code: 11D2259240
  • Facility Name: GEORGIA DIAGNOSTIC CLASSIFICATION PRISON
  • Facility Address: 2978 HWY 36 WEST
    JACKSON, GA
    ZIP 30233
  • Facility Phone: 678 470-3977
  • Facility Type: Prison
  • Facility Type: Waiver
  • Lab Director: JAYNA THOMAS
  • NPI Number: 1689165482
  • Taxonomy: 3336I0012X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2259240
LAB Type Prison
Facility Name GEORGIA DIAGNOSTIC CLASSIFICATION PRISON
Street 2978 HWY 36 WEST
City JACKSON
State GA
ZIP 30233
Phone 678 470-3977
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/4/2024
Certificate Expiration Date 5/3/2026
Facility Type Prison
Lab Director JAYNA THOMAS

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