11D2290791 CLIA NUMBER - ALLEN CRAWFORD FNP-PC

Laboratory Demographics

  • CLIA Code: 11D2290791
  • Facility Name: ALLEN CRAWFORD FNP-PC
  • Facility Address: 22 CROSS STREET
    HAZLEHURST, GA
    ZIP 31539
  • Facility Phone: 912 375-4884
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KIRK MUNSAYAC
  • NPI Number: 1013793710
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 11D2290791
LAB Type Physician Office
Facility Name ALLEN CRAWFORD FNP-PC
Street 22 CROSS STREET
City HAZLEHURST
State GA
ZIP 31539
Phone 912 375-4884
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/2/2023
Certificate Expiration Date 10/1/2025
Facility Type Physician Office
Lab Director KIRK MUNSAYAC

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