11D2290321 CLIA NUMBER - ELITE AMBULANCE TRANSPORTATION

Laboratory Demographics

  • CLIA Code: 11D2290321
  • Facility Name: ELITE AMBULANCE TRANSPORTATION
  • Facility Address: 152 NEW STREET, SUITE 103-E
    MACON, GA
    ZIP 31201
  • Facility Phone: 478 845-8500
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: KEDRICK D. MARCUS
  • NPI Number: 1487167250
  • Taxonomy: 341600000X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 11D2290321
LAB Type Ambulance
Facility Name ELITE AMBULANCE TRANSPORTATION
Street 152 NEW STREET, SUITE 103-E
City MACON
State GA
ZIP 31201
Phone 478 845-8500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/25/2025
Certificate Expiration Date 9/24/2027
Facility Type Ambulance
Lab Director KEDRICK D. MARCUS

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