11D2290877 CLIA NUMBER - WILLINGWAY, INC DBA WILLINGWAY

Laboratory Demographics

CLIA Number: 11D2290877

Facility Name: WILLINGWAY, INC DBA WILLINGWAY

Facility Address:
1225 AUGUSTA W PARKWAY
AUGUSTA, GA
ZIP 30909
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Facility Phone Number: 888 822-1750

Facility Type: Other - OUTPATIENT CLINIC

Certificate Type: Waiver

NPI Number: 1356129340

Taxonomy: 261QR0405X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D2290877
LAB Type	Other - OUTPATIENT CLINIC
Facility Name	WILLINGWAY, INC DBA WILLINGWAY
Street	1225 AUGUSTA W PARKWAY
City	AUGUSTA
State	GA
ZIP	30909
Phone	888 822-1750
CertificateType	4
CertificateEffectiveDate	10/3/2023
CertificateExpirationDate	10/2/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024