11D2265869 CLIA NUMBER - CENTERWELL SENIOR PRIMARY CARE (GA) P C- VICTORY HEIGHTS

Laboratory Demographics

  • CLIA Code: 11D2265869
  • Facility Name: CENTERWELL SENIOR PRIMARY CARE (GA) P C- VICTORY HEIGHTS
  • Facility Address: 2104 E VICTORY DRIVE
    SAVANNAH, GA
    ZIP 31404
  • Facility Phone: 912 600-1222
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JODINE M. SEJOUR DONATIEN
  • NPI Number: 1679205926
  • Taxonomy: 332900000X - Non-Pharmacy Dispensing Site

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CLIA Record

Field Name Field Value
CLIA Number 11D2265869
LAB Type Physician Office
Facility Name CENTERWELL SENIOR PRIMARY CARE (GA) P C- VICTORY HEIGHTS
Street 2104 E VICTORY DRIVE
City SAVANNAH
State GA
ZIP 31404
Phone 912 600-1222
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/3/2024
Certificate Expiration Date 8/2/2026
Facility Type Physician Office
Lab Director JODINE M. SEJOUR DONATIEN

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