11D2260310 CLIA NUMBER - SOUTHERN CORRECTIONAL MEDICINE, LLC

Laboratory Demographics

  • CLIA Code: 11D2260310
  • Facility Name: SOUTHERN CORRECTIONAL MEDICINE, LLC
  • Facility Address: 921 SMITH AVENUE
    THOMASVILLE, GA
    ZIP 31792
  • Facility Phone: 912 283-5260
  • Facility Type: Other - COUNTY JAIL
  • Facility Type: Waiver
  • Lab Director: PETER WROBEL
  • NPI Number: 1922266014
  • Taxonomy: 103TF0200X - Psychologist

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2260310
LAB Type Other - COUNTY JAIL
Facility Name SOUTHERN CORRECTIONAL MEDICINE, LLC
Street 921 SMITH AVENUE
City THOMASVILLE
State GA
ZIP 31792
Phone 912 283-5260
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/17/2024
Certificate Expiration Date 5/16/2026
Facility Type Other - COUNTY JAIL
Lab Director PETER WROBEL

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