EAST GEORGIA REGIONAL MEDICAL CENTER, LLC
NPI 1073537114
Pediatrics in Statesboro, GA

Active since July 26, 2006CLIA Certified · 2 labs
1497 FAIR RD, SUITE 206, STATESBORO, GA 30458(912) 871-5437 Get Directions Write a Review

NPPES record last updated: December 18, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About East Georgia Regional Medical Center, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EAST GEORGIA REGIONAL MEDICAL CENTER, LLC (NPI 1073537114) is a healthcare organization registered as a pediatrics in Statesboro, Georgia and active in the NPI registry since July 2006. The organization holds 2 active CLIA laboratory certificates and lists Paula Lalor, Director, as its authorized official.

NPPES Registry Identity

NPI1073537114
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameEAST GEORGIA REGIONAL MEDICAL CENTER, LLC
Location Address1497 FAIR RD, SUITE 206Statesboro, GA 30458-0822
Mailing Address1497 Fair Rd, Suite 206Statesboro, GA 30458-0822 · (912) 871-5437
Organization SubpartNo
Authorized OfficialPaula LalorDirector · (615) 925-4565
Enumeration DateJuly 26, 2006
Last NPPES UpdateDecember 18, 2017
NPI 1073537114 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

1497 FAIR RD, Statesboro, GA 30458

Other Identifiers 1

Medicaid249619966AGA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2115029

East Georgia Regional Medical Office Building · Statesboro, GA
Active · expires Jun 26, 2028
CLIA Number11D2115029
Laboratory TypeAncillary Testing Site In Health Care Center
Certificate Effective DateJune 27, 2026
Certificate Expiration DateJune 26, 2028
Laboratory DirectorDr. Anjana Vijayvargiya
Laboratory Phone(912) 486-1500
Laboratory LocationEast Georgia Regional Medical Office Building1497 Fair Road, Statesboro, GA 30458
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Accreditation 11D0261102

East Georgia Regional Medical Center · Statesboro, GA
Active · expires Nov 30, 2027
CLIA Number11D0261102
Laboratory TypeHospital
Certificate Effective DateDecember 1, 2025
Certificate Expiration DateNovember 30, 2027
Laboratory DirectorDr. Robert Wade
Laboratory Phone(912) 764-6671
Laboratory LocationEast Georgia Regional Medical Center1499 Fair Road, Statesboro, GA 30458
CLIA data matches this NPI record on: Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Emergency Medicine
1497 FAIR RD
STATESBORO, GA 30458
Specialist
1497 FAIR RD, SUITE 201
STATESBORO, GA 30458
Obstetrics & Gynecology
1497 FAIR RD, SUITE 300
STATESBORO, GA 30458
Internal Medicine (Cardiovascular Disease)
1497 FAIR RD, SUITE 305
STATESBORO, GA 30458
Nurse Anesthetist, Certified Registered
1497 FAIR RD, SUITE 102
STATESBORO, GA 30458
Nurse Practitioner (Obstetrics & Gynecology)
1497 FAIR RD, SUITE 300
STATESBORO, GA 30458
Surgery
1497 FAIR RD, SUITE 103
STATESBORO, GA 30458
Pediatrics (Pediatric Hematology-Oncology)
1497 FAIR RD, SUITE 200
STATESBORO, GA 30458

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is East Georgia Regional Medical Center, LLC's NPI number?

The NPI number for East Georgia Regional Medical Center, LLC is 1073537114. It was assigned to this organization in the NPPES registry on July 26, 2006.

Where is East Georgia Regional Medical Center, LLC located?

East Georgia Regional Medical Center, LLC is located at 1497 Fair Rd Suite 206, Statesboro, GA 30458. The listed phone number is (912) 871-5437.

What is East Georgia Regional Medical Center, LLC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does East Georgia Regional Medical Center, LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for East Georgia Regional Medical Center, LLC was last updated on December 18, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.