11D2298369 CLIA NUMBER - LAWRENCE A UKPONG MD PC

Laboratory Demographics

  • CLIA Code: 11D2298369
  • Facility Name: LAWRENCE A UKPONG MD PC
  • Facility Address: 1 SWEET BAY COURT, SUITE B
    MOULTRIE, GA
    ZIP 31768
  • Facility Phone: 229 891-9087
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LAWRENCE A. UKPONG
  • NPI Number: 1376700807
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2298369
LAB Type Physician Office
Facility Name LAWRENCE A UKPONG MD PC
Street 1 SWEET BAY COURT, SUITE B
City MOULTRIE
State GA
ZIP 31768
Phone 229 891-9087
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/1/2024
Certificate Expiration Date 1/31/2026
Facility Type Physician Office
Lab Director LAWRENCE A. UKPONG

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