11D2276255 CLIA NUMBER - FAIRVIEW PARK SPECIALISTS GENERAL AND BARIATRIC SURGERY

Laboratory Demographics

  • CLIA Code: 11D2276255
  • Facility Name: FAIRVIEW PARK SPECIALISTS GENERAL AND BARIATRIC SURGERY
  • Facility Address: 200 FAIRVIEW PARK DRIVE
    DUBLIN, GA
    ZIP 31021
  • Facility Phone: 478 410-5754
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ERIC CHUNG
  • NPI Number: 1093769044
  • Taxonomy: 273Y00000X - Rehabilitation Unit

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CLIA Record

Field Name Field Value
CLIA Number 11D2276255
LAB Type Physician Office
Facility Name FAIRVIEW PARK SPECIALISTS GENERAL AND BARIATRIC SURGERY
Street 200 FAIRVIEW PARK DRIVE
City DUBLIN
State GA
ZIP 31021
Phone 478 410-5754
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/6/2025
Certificate Expiration Date 2/5/2027
Facility Type Physician Office
Lab Director ERIC CHUNG

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