CLIA lab
CLIA 11D2169069: Georgia Kidney & Hypertension Clinic
Moultrie, GA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 11D2169069 belongs to Georgia Kidney & Hypertension Clinic in Moultrie, GA.
Certificate of Waiver, effective July 16, 2025, expires July 15, 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
- July 16, 2025
- Certificate expiration
- July 15, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- July 16, 2019
- 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
- 11D2169069
- Lab name
- Georgia Kidney & Hypertension Clinic
- Additional name
- Moultrie Specialty Clinic
- Address
- 449 31st Avenue, SE, Moultrie, GA 31768
- Phone
- (229) 227-1595
- Fax
- (229) 227-1385
Annual test volume the lab reported
- Waived tests
- 480
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- 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 Georgia Kidney & Hypertension Clinic in Moultrie?
11D2169069, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Georgia Kidney & Hypertension Clinic hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 11D2169069 expire?
The CMS file lists July 15, 2027 as the certificate expiration date; the certificate took effect July 16, 2025.