CLIA lab
CLIA 11D2305583: Southeast Medical Group, PC
Fort Valley, GA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 11D2305583 belongs to Southeast Medical Group, PC in Fort Valley, GA.
Certificate of Waiver, effective June 4, 2026, expires June 3, 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
- June 4, 2026
- Certificate expiration
- June 3, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- June 4, 2024
- Facility type
- Physician office
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
- Directly affiliated labs
- 6
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 11D2305583
- Lab name
- Southeast Medical Group, PC
- Additional name
- DBA Houston Primary Care
- Address
- 701 Bluebird Boulevard, Fort Valley, GA 31030
- Phone
- (770) 442-1911
- Fax
- (770) 663-8905
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.
Affiliated CLIA numbers
Other labs in Fort Valley, GA
- Atrium Health Navicent Campus Health ClinicCertificate of Waiver, School or student health service11D2282921
- Atrium Health Navicent Primary Care Fort ValleyCertificate of Waiver, Physician office11D0950612
- Brown Family Practice, LLCCertificate for Provider-Performed Microscopy Procedures, Physician office11D0885502
- Careconnect Convenient CareCertificate of Waiver, Federally qualified health center11D2142850
- Church Home Rehabilitation & Healthcare, LLCCertificate of Waiver, Skilled nursing or nursing facility11D0263760
- Cornerstone Medical AssociatesCertificate of Waiver, Physician office11D0975344
- Cynthia L Giles DO LLCCertificate of Waiver, Physician office11D0991709
- Everside Health HSM Fort ValleyCertificate of Waiver, Other11D2298855
- Eyesight AssociatesCertificate of Waiver, Physician office11D2110393
- Five Points PharmacyCertificate of Waiver, Pharmacy11D2169539
Related
Questions
What is the CLIA number for Southeast Medical Group, PC in Fort Valley?
11D2305583, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Southeast Medical Group, PC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 11D2305583 expire?
The CMS file lists June 3, 2028 as the certificate expiration date; the certificate took effect June 4, 2026.