11D2330239 CLIA NUMBER - BEWELL INTEGRATIVE HEALTH

Laboratory Demographics

  • CLIA Code: 11D2330239
  • Facility Name: BEWELL INTEGRATIVE HEALTH
  • Facility Address: 1095 US HIGHWAY 82 W
    LEESBURG, GA
    ZIP 31763
  • Facility Phone: 229 800-8102
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GAIL M. RICKER
  • NPI Number: 1629863006
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 11D2330239
LAB Type Physician Office
Facility Name BEWELL INTEGRATIVE HEALTH
Street 1095 US HIGHWAY 82 W
City LEESBURG
State GA
ZIP 31763
Phone 229 800-8102
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/12/2025
Certificate Expiration Date 9/11/2027
Facility Type Physician Office
Lab Director GAIL M. RICKER

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