CLIA lab
CLIA 11D0645917: Pruitthealth - Old Capitol
Louisville, GA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 11D0645917 belongs to Pruitthealth - Old Capitol in Louisville, GA.
Certificate of Waiver, effective September 1, 2026, expires August 31, 2028.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- September 1, 2026
- Certificate expiration
- August 31, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- September 24, 1994
- Facility type
- Skilled nursing or nursing facility
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 11D0645917
- Lab name
- Pruitthealth - Old Capitol
- Additional name
- Fdba the Heritage of Old Capitol
- Address
- 310 Highway #1 Bypass, Louisville, GA 30434
- Phone
- (478) 625-9473
- Fax
- (478) 625-3741
Annual test volume the lab reported
- Waived tests
- 7,570
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Care facility at this address
- Pruitthealth - Old CapitolCMS Care Compare ratings for the facility at the same street address
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Related
Questions
What is the CLIA number for Pruitthealth - Old Capitol in Louisville?
11D0645917, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Pruitthealth - Old Capitol hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 11D0645917 expire?
The CMS file lists August 31, 2028 as the certificate expiration date; the certificate took effect September 1, 2026.