11D2296436 CLIA NUMBER - ATHENS FAMILY MEDICINE, LLC

Laboratory Demographics

  • CLIA Code: 11D2296436
  • Facility Name: ATHENS FAMILY MEDICINE, LLC
  • Facility Address: 300 HAWTHORNE LANE
    ATHENS, GA
    ZIP 30606
  • Facility Phone: 561 353-1225
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALVIN WILSON
  • NPI Number: 1780851170
  • Taxonomy: 261QM2500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2296436
LAB Type Physician Office
Facility Name ATHENS FAMILY MEDICINE, LLC
Street 300 HAWTHORNE LANE
City ATHENS
State GA
ZIP 30606
Phone 561 353-1225
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/28/2023
Certificate Expiration Date 12/27/2025
Facility Type Physician Office
Lab Director ALVIN WILSON

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