11D2307199 CLIA NUMBER - PREMIER VASCULAR

Laboratory Demographics

  • CLIA Code: 11D2307199
  • Facility Name: PREMIER VASCULAR
  • Facility Address: 1902 FORSYTH STREET
    MACON, GA
    ZIP 31201
  • Facility Phone: 478 250-9785
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: MATTHEW CHANDLER
  • NPI Number: 1942981618
  • Taxonomy: 2086S0129X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 11D2307199
LAB Type Physician Office
Facility Name PREMIER VASCULAR
Street 1902 FORSYTH STREET
City MACON
State GA
ZIP 31201
Phone 478 250-9785
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 7/3/2024
Certificate Expiration Date 7/2/2026
Facility Type Physician Office
Lab Director MATTHEW CHANDLER

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