CLIA lab
CLIA 11D2057902: Premise Health of Georgia Medical, PC
Vidalia, GA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 11D2057902 belongs to Premise Health of Georgia Medical, PC in Vidalia, GA.
Certificate of Waiver, effective April 25, 2025, expires April 24, 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 25, 2025
- Certificate expiration
- April 24, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- April 25, 2013
- Facility type
- Physician office
- 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
- 11D2057902
- Lab name
- Premise Health of Georgia Medical, PC
- Address
- 1122 West North Street, Vidalia, GA 30474
- Phone
- (912) 537-8488
- Fax
- (912) 537-7303
Annual test volume the lab reported
- Waived tests
- 100
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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Related
Questions
What is the CLIA number for Premise Health of Georgia Medical, PC in Vidalia?
11D2057902, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Premise Health of Georgia Medical, PC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 11D2057902 expire?
The CMS file lists April 24, 2027 as the certificate expiration date; the certificate took effect April 25, 2025.