11D2293613 CLIA NUMBER - BRUNSWICK MEDICAL

Laboratory Demographics

  • CLIA Code: 11D2293613
  • Facility Name: BRUNSWICK MEDICAL
  • Facility Address: 1111 GLYNCO PARKWAY, BLDG 1, SUITE 10
    BRUNSWICK, GA
    ZIP 31525
  • Facility Phone: 912 574-4313
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JEUSLYN CHANDLER
  • NPI Number: 1639959299
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2293613
LAB Type Physician Office
Facility Name BRUNSWICK MEDICAL
Street 1111 GLYNCO PARKWAY, BLDG 1, SUITE 10
City BRUNSWICK
State GA
ZIP 31525
Phone 912 574-4313
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/13/2023
Certificate Expiration Date 11/12/2025
Facility Type Physician Office
Lab Director JEUSLYN CHANDLER

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This page was last updated on: 6/4/2025