11D2313026 CLIA NUMBER - SHELLMAN MEDICAL LLC

Laboratory Demographics

  • CLIA Code: 11D2313026
  • Facility Name: SHELLMAN MEDICAL LLC
  • Facility Address: 67 W RAILROAD STREET
    SHELLMAN, GA
    ZIP 39886
  • Facility Phone: 229 679-2100
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WAEL A. AZER
  • NPI Number: 1134136047
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2313026
LAB Type Physician Office
Facility Name SHELLMAN MEDICAL LLC
Street 67 W RAILROAD STREET
City SHELLMAN
State GA
ZIP 39886
Phone 229 679-2100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/23/2024
Certificate Expiration Date 10/22/2026
Facility Type Physician Office
Lab Director WAEL A. AZER

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