11D2294799 CLIA NUMBER - ST MARYS BEHAVIORAL HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 11D2294799
  • Facility Name: ST MARYS BEHAVIORAL HEALTH CENTER
  • Facility Address: 1020 MCDOWELL STREET
    SAINT MARYS, GA
    ZIP 31558
  • Facility Phone: 478 957-3176
  • Facility Type: Other - RES PSYCH FACILITY
  • Facility Type: Waiver
  • Lab Director: PAUL PANCHAJANYA
  • NPI Number: 1720275274
  • Taxonomy: 111N00000X - Chiropractor

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CLIA Record

Field Name Field Value
CLIA Number 11D2294799
LAB Type Other - RES PSYCH FACILITY
Facility Name ST MARYS BEHAVIORAL HEALTH CENTER
Street 1020 MCDOWELL STREET
City SAINT MARYS
State GA
ZIP 31558
Phone 478 957-3176
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 Other - RES PSYCH FACILITY
Lab Director PAUL PANCHAJANYA

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