11D2278749 CLIA NUMBER - HOMETOWN OCCUPATIONAL MEDICINE, LLC

Laboratory Demographics

  • CLIA Code: 11D2278749
  • Facility Name: HOMETOWN OCCUPATIONAL MEDICINE, LLC
  • Facility Address: 89 SANDY RUN ROAD, SUITE 500
    BONAIRE, GA
    ZIP 31005
  • Facility Phone: 478 972-0403
  • Facility Type: Other - OCCUPATIONAL MED
  • Facility Type: Waiver
  • Lab Director: BRIAN J. LUDWIG
  • NPI Number: 1609553965
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 11D2278749
LAB Type Other - OCCUPATIONAL MED
Facility Name HOMETOWN OCCUPATIONAL MEDICINE, LLC
Street 89 SANDY RUN ROAD, SUITE 500
City BONAIRE
State GA
ZIP 31005
Phone 478 972-0403
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/23/2025
Certificate Expiration Date 3/22/2027
Facility Type Other - OCCUPATIONAL MED
Lab Director BRIAN J. LUDWIG

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