SOUTHEAST GEORGIA PEDIATRICS
NPI 1457613192
Clinic/Center - Primary Care in Waycross, GA
About Southeast Georgia Pediatrics NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTHEAST GEORGIA PEDIATRICS (NPI 1457613192) is a healthcare organization registered as a primary care in Waycross, Georgia and active in the NPI registry since June 2012. The organization holds a CLIA Certificate of Compliance certificate valid through August 13, 2026 and lists Eugene Wynn Kallay, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
CLIA Laboratory Certificates CMS CLIA
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 Compliance 11D2044019
Southeast Georgia Pediatrics, LLC · Waycross, GAOther Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Southeast Georgia Pediatrics's NPI number?
The NPI number for Southeast Georgia Pediatrics is 1457613192. It was assigned to this organization in the NPPES registry on June 8, 2012.
Where is Southeast Georgia Pediatrics located?
Southeast Georgia Pediatrics is located at 1701 Boulevard Sq Ste D, Waycross, GA 31501. The listed phone number is (912) 387-0445.
What is Southeast Georgia Pediatrics's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Does Southeast Georgia Pediatrics hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 11D2044019) is associated with this NPI, valid through August 13, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Southeast Georgia Pediatrics was last updated on June 15, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.
