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STATESBORO IMAGING CENTER, P.C.
NPI 1750413613
Physiological Laboratory in Statesboro, GA

Active since March 09, 2007CLIA 11D2009817 · Waiver
8 LESTER RD, STATESBORO, GA 30458(912) 764-5656(912) 764-7522 Get Directions Write a Review

NPPES record last updated: March 3, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Statesboro Imaging Center, P.c. NPPES

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

STATESBORO IMAGING CENTER, P.C. (NPI 1750413613) is a healthcare organization registered as a physiological laboratory in Statesboro, Georgia and active in the NPI registry since March 2007. The organization holds a CLIA Waiver certificate valid through July 14, 2028 and lists Connie B. Connell, Coo, as its authorized official.

NPPES Registry Identity

NPI1750413613
Entity TypeOrganization
Primary Taxonomy293D00000X
Legal Business NameSTATESBORO IMAGING CENTER, P.C.
Location Address8 LESTER RDStatesboro, GA 30458-4786
Mailing Address8 Lester RdStatesboro, GA 30458-4786 · (912) 764-5656 · Fax (912) 764-7522
Phone(912) 764-5656
Fax(912) 764-7522
Organization SubpartNo
Authorized OfficialConnie B. ConnellCoo · (912) 764-5656
Enumeration DateMarch 9, 2007
Last NPPES UpdateMarch 3, 2010
✔ NPI 1750413613 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysiological LaboratoryLaboratories
Taxonomy Code293D00000X
Definition
A laboratory that operates independently of a hospital and physician's office to furnish physiological diagnostic services (e.g. EEG's , EKG's, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services.
8 LESTER RD, Statesboro, GA 30458
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Other Identifiers 1

Medicare ID-Type UnspecifiedGRP2523GA · Sic Medicare Number

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 Waiver 11D2009817

Statesboro Imaging Center, PC · Statesboro, GA
Active · expires Jul 14, 2028
CLIA Number11D2009817
Laboratory TypeIdtf (in Process)
Certificate Effective DateJuly 15, 2026
Certificate Expiration DateJuly 14, 2028
Laboratory DirectorDr. Anjana Vijayvargiya
Laboratory Phone(912) 764-5656
Laboratory LocationStatesboro Imaging Center, PC8 Coach Lee Hill Boulevard, Statesboro, GA 30458
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

TECHNICAL DIAGNOSTIC IMAGING, LLC
Physiological Laboratory
8 LESTER RD
STATESBORO, GA 30458
Bulloch County (912) 764-5656
STATESBORO IMAGING CENTER, P.C.
Physiological Laboratory
8 LESTER RD
STATESBORO, GA 30458
Bulloch County (912) 764-5656

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 Statesboro Imaging Center, P.C.'s NPI number?

The NPI number for Statesboro Imaging Center, P.C. is 1750413613. It was assigned to this organization in the NPPES registry on March 9, 2007.

Where is Statesboro Imaging Center, P.C. located?

Statesboro Imaging Center, P.C. is located at 8 Lester Rd, Statesboro, GA 30458. The listed phone number is (912) 764-5656.

What is Statesboro Imaging Center, P.C.'s specialty?

The primary specialty registered for this NPI is Physiological Laboratory with taxonomy code 293D00000X.

Does Statesboro Imaging Center, P.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2009817) is associated with this NPI, valid through July 14, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Statesboro Imaging Center, P.C. was last updated on March 3, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.