11D2295402 CLIA NUMBER - AZALEA PEDIATRICS, LLC

Laboratory Demographics

  • CLIA Code: 11D2295402
  • Facility Name: AZALEA PEDIATRICS, LLC
  • Facility Address: 6801 RIVER ORAD, SUITE 401
    COLUMBUS, GA
    ZIP 31904
  • Facility Phone: 762 208-5025
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AMY E. BROWN
  • NPI Number: 1770367203
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D2295402
LAB Type Physician Office
Facility Name AZALEA PEDIATRICS, LLC
Street 6801 RIVER ORAD, SUITE 401
City COLUMBUS
State GA
ZIP 31904
Phone 762 208-5025
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/12/2023
Certificate Expiration Date 12/11/2025
Facility Type Physician Office
Lab Director AMY E. BROWN

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