11D2305942 CLIA NUMBER - OGEECHEE OB/GYN

Laboratory Demographics

  • CLIA Code: 11D2305942
  • Facility Name: OGEECHEE OB/GYN
  • Facility Address: 209-C MIMS ROAD
    SYLVANIA, GA
    ZIP 30467
  • Facility Phone: (912) 871-6206
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAMES SMALL
  • NPI Number: 1053380592
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 11D2305942
LAB Type Physician Office
Facility Name OGEECHEE OB/GYN
Street 209-C MIMS ROAD
City SYLVANIA
State GA
ZIP 30467
Phone 9128716206
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/10/2024
Certificate Expiration Date 6/9/2026
Facility Type Physician Office
Lab Director JAMES SMALL

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This page was last updated on: 5/18/2026