11D2259361 CLIA NUMBER - MITCHELL COUNTY PEDIATRICS & HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 11D2259361
  • Facility Name: MITCHELL COUNTY PEDIATRICS & HEALTH CENTER
  • Facility Address: 94 EAST OAKLAND AVENUE, SUITE A
    CAMILLA, GA
    ZIP 31730
  • Facility Phone: 229 336-9769
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANTONIO R. MILLER
  • NPI Number: 1932288271
  • Taxonomy: 208000000X - Pediatrics

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2259361
LAB Type Physician Office
Facility Name MITCHELL COUNTY PEDIATRICS & HEALTH CENTER
Street 94 EAST OAKLAND AVENUE, SUITE A
City CAMILLA
State GA
ZIP 31730
Phone 229 336-9769
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/5/2024
Certificate Expiration Date 5/4/2026
Facility Type Physician Office
Lab Director ANTONIO R. MILLER

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