CLIA lab
CLIA 11D1040007: Magnolia Manor South
Moultrie, GA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 11D1040007 belongs to Magnolia Manor South in Moultrie, GA.
Certificate of Waiver, effective April 27, 2025, expires April 26, 2027.
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
- April 27, 2025
- Certificate expiration
- April 26, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- April 27, 2005
- Facility type
- Other
- Ownership (control type)
- Religious affiliation
- 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
- 11D1040007
- Lab name
- Magnolia Manor South
- Address
- 3011 Veterans Parkway S, Moultrie, GA 31788
- Phone
- (229) 985-0265
- Fax
- (229) 891-2174
Annual test volume the lab reported
- Waived tests
- 2,500
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Moultrie, GA
- Betty V Koukism MDCertificate of Waiver, Physician office11D2149464
- Careconnect PediatricsCertificate of Waiver, Federally qualified health center11D2153051
- Careconnect Urgent CareCertificate of Waiver, Federally qualified health center11D2101706
- Ccsg IncCertificate of Waiver, Physician office11D2224496
- Chancy Drugs MoultireCertificate of Waiver, Pharmacy11D2184893
- Colquit Regional Diaylsis HomeCertificate of Waiver, End stage renal disease dialysis facility11D2329957
- Colquitt Co Board of EducationCertificate of Waiver, School or student health service11D2135673
- Colquitt County EMSCertificate of Waiver, Ambulance11D2199858
- Colquitt County JailCertificate of Waiver, Prison11D2292378
- Colquitt Regional Community ParamedicineCertificate of Waiver, Other11D2277986
Related
Questions
What is the CLIA number for Magnolia Manor South in Moultrie?
11D1040007, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Magnolia Manor South hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 11D1040007 expire?
The CMS file lists April 26, 2027 as the certificate expiration date; the certificate took effect April 27, 2025.