11D2269480 CLIA NUMBER - SURF AND SAND PEDIATRICS

Laboratory Demographics

  • CLIA Code: 11D2269480
  • Facility Name: SURF AND SAND PEDIATRICS
  • Facility Address: 1111 GLYNCO PARKWAY SUITE 31
    BRUNSWICK, GA
    ZIP 31525
  • Facility Phone: 912 456-3605
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AMANDA G. JOSEPH
  • NPI Number: 1770207482
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D2269480
LAB Type Physician Office
Facility Name SURF AND SAND PEDIATRICS
Street 1111 GLYNCO PARKWAY SUITE 31
City BRUNSWICK
State GA
ZIP 31525
Phone 912 456-3605
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/27/2024
Certificate Expiration Date 9/26/2026
Facility Type Physician Office
Lab Director AMANDA G. JOSEPH

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