11D2262635 CLIA NUMBER - SOUTH GEORGIA PHYSICIANS GROUP LLC

Laboratory Demographics

  • CLIA Code: 11D2262635
  • Facility Name: SOUTH GEORGIA PHYSICIANS GROUP LLC
  • Facility Address: 407 W ONEIDA STREET
    WAYCROSS, GA
    ZIP 31501
  • Facility Phone: 912 338-0065
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NEHA KAKKAR
  • NPI Number: 1336560952
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2262635
LAB Type Physician Office
Facility Name SOUTH GEORGIA PHYSICIANS GROUP LLC
Street 407 W ONEIDA STREET
City WAYCROSS
State GA
ZIP 31501
Phone 912 338-0065
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/16/2024
Certificate Expiration Date 6/15/2026
Facility Type Physician Office
Lab Director NEHA KAKKAR

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