11D2294782 CLIA NUMBER - BURKETT FAMILY PRACTICE, LLC

Laboratory Demographics

  • CLIA Code: 11D2294782
  • Facility Name: BURKETT FAMILY PRACTICE, LLC
  • Facility Address: 38 S TALLAHASSEE STREET, SUITE B
    HAZLEHURST, GA
    ZIP 31539
  • Facility Phone: 912 699-8800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANGELA M. BURKETT
  • NPI Number: 1669180741
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2294782
LAB Type Physician Office
Facility Name BURKETT FAMILY PRACTICE, LLC
Street 38 S TALLAHASSEE STREET, SUITE B
City HAZLEHURST
State GA
ZIP 31539
Phone 912 699-8800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/30/2023
Certificate Expiration Date 11/29/2025
Facility Type Physician Office
Lab Director ANGELA M. BURKETT

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