11D2290865 CLIA NUMBER - GB ENTITY DBA GLORY EMS

Laboratory Demographics

  • CLIA Code: 11D2290865
  • Facility Name: GB ENTITY DBA GLORY EMS
  • Facility Address: 801 29TH STREET
    COLUMBUS, GA
    ZIP 31904
  • Facility Phone: 706 247-8442
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: COURTLAND C. DIXON
  • NPI Number: 1801670112
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 11D2290865
LAB Type Ambulance
Facility Name GB ENTITY DBA GLORY EMS
Street 801 29TH STREET
City COLUMBUS
State GA
ZIP 31904
Phone 706 247-8442
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/3/2023
Certificate Expiration Date 10/2/2025
Facility Type Ambulance
Lab Director COURTLAND C. DIXON

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