11D2285290 CLIA NUMBER - MEDLINK MOBILE 1

Laboratory Demographics

  • CLIA Code: 11D2285290
  • Facility Name: MEDLINK MOBILE 1
  • Facility Address: 11 CHARLIE MORRIS ROAD
    COLBERT, GA
    ZIP 30628
  • Facility Phone: 706 788-3234
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: SAMUEL KAZUC SENCIL
  • NPI Number: 1669833364
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2285290
LAB Type Federally Qualified Health Center
Facility Name MEDLINK MOBILE 1
Street 11 CHARLIE MORRIS ROAD
City COLBERT
State GA
ZIP 30628
Phone 706 788-3234
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/11/2025
Certificate Expiration Date 7/10/2027
Facility Type Federally Qualified Health Center
Lab Director SAMUEL KAZUC SENCIL

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