11D2328586 CLIA NUMBER - MG LAB SERVICES

Laboratory Demographics

  • CLIA Code: 11D2328586
  • Facility Name: MG LAB SERVICES
  • Facility Address: 31 PINE GROVE ROAD
    LOCUST GROVE, GA
    ZIP 30248
  • Facility Phone: (470) 894-0077
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: MARJORIE PETIT
  • NPI Number: 1508774589
  • Taxonomy: 261QP0905X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2328586
LAB Type Mobile Laboratory
Facility Name MG LAB SERVICES
Street 31 PINE GROVE ROAD
City LOCUST GROVE
State GA
ZIP 30248
Phone 4708940077
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/13/2025
Certificate Expiration Date 8/12/2027
Facility Type Mobile Laboratory
Lab Director MARJORIE PETIT

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This page was last updated on: 9/8/2026