11D2269604 CLIA NUMBER - MOLE'T HEALTH AND WELLNESS, PC

Laboratory Demographics

  • CLIA Code: 11D2269604
  • Facility Name: MOLE'T HEALTH AND WELLNESS, PC
  • Facility Address: 4693 LOG CABIN DRIVE
    MACON, GA
    ZIP 31204
  • Facility Phone: 478 227-4113
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: TAMIKO MOLET
  • NPI Number: 1487376646
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2269604
LAB Type Practitioner Other
Facility Name MOLE'T HEALTH AND WELLNESS, PC
Street 4693 LOG CABIN DRIVE
City MACON
State GA
ZIP 31204
Phone 478 227-4113
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/29/2024
Certificate Expiration Date 9/28/2026
Facility Type Practitioner Other
Lab Director TAMIKO MOLET

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