11D2271213 CLIA NUMBER - PRUITTHEALTH-CREEKSIDE, LLC

Laboratory Demographics

  • CLIA Code: 11D2271213
  • Facility Name: PRUITTHEALTH-CREEKSIDE, LLC
  • Facility Address: 2021 SCOTT ROAD
    AUGUSTA, GA
    ZIP 30906
  • Facility Phone: 706 247-8310
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: SUZANNE GERHARDT
  • NPI Number: 1104536077
  • Taxonomy: 314000000X - Skilled Nursing Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2271213
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PRUITTHEALTH-CREEKSIDE, LLC
Street 2021 SCOTT ROAD
City AUGUSTA
State GA
ZIP 30906
Phone 706 247-8310
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/31/2024
Certificate Expiration Date 10/30/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director SUZANNE GERHARDT

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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