11D2285945 CLIA NUMBER - MEDLINK HARTWELL

Laboratory Demographics

  • CLIA Code: 11D2285945
  • Facility Name: MEDLINK HARTWELL
  • Facility Address: 63 WEST GIBSON STREET
    HARTWELL, GA
    ZIP 30643
  • Facility Phone: 706 376-6100
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: DANIEL HARRY GORDON
  • NPI Number: 1275643272
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2285945
LAB Type Federally Qualified Health Center
Facility Name MEDLINK HARTWELL
Street 63 WEST GIBSON STREET
City HARTWELL
State GA
ZIP 30643
Phone 706 376-6100
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 7/20/2025
Certificate Expiration Date 7/19/2027
Facility Type Federally Qualified Health Center
Lab Director DANIEL HARRY GORDON

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