11D2284753 CLIA NUMBER - CRISP COUNTY JAIL

Laboratory Demographics

CLIA Number: 11D2284753

Facility Name: CRISP COUNTY JAIL

Facility Address:
196 GA HWY 300 SOUTH
CORDELE, GA
ZIP 31015
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Facility Phone Number: 423 206-2002

Facility Type: Other - JAIL MEDICAL UNIT

Certificate Type: Waiver

NPI Number: 1427093285

Taxonomy: 251K00000X - Public Health or Welfare

CLIA Record

Field Name	Field Value
CLIA Number	11D2284753
LAB Type	Other - JAIL MEDICAL UNIT
Facility Name	CRISP COUNTY JAIL
Street	196 GA HWY 300 SOUTH
City	CORDELE
State	GA
ZIP	31015
Phone	423 206-2002
CertificateType	4
CertificateEffectiveDate	6/28/2023
CertificateExpirationDate	6/27/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024