11D2269135 CLIA NUMBER - LHCG CCXXVIII, LLC DBA THREE RIVERS HOME HEALTH SERVICES

Laboratory Demographics

  • CLIA Code: 11D2269135
  • Facility Name: LHCG CCXXVIII, LLC DBA THREE RIVERS HOME HEALTH SERVICES
  • Facility Address: 115 NORTHWEST MAIN STREET
    VIDALIA, GA
    ZIP 30474
  • Facility Phone: 478 374-3468
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: BROOKE SMITH
  • NPI Number: 1265160170
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 11D2269135
LAB Type Home Health Agency
Facility Name LHCG CCXXVIII, LLC DBA THREE RIVERS HOME HEALTH SERVICES
Street 115 NORTHWEST MAIN STREET
City VIDALIA
State GA
ZIP 30474
Phone 478 374-3468
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/21/2024
Certificate Expiration Date 9/20/2026
Facility Type Home Health Agency
Lab Director BROOKE SMITH

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