Healthcare Provider Details

I. General information

NPI: 1154202810
Provider Name (Legal Business Name): CLINICAL DIAGNOSTIC SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 HILL ST
WAYCROSS GA
31501-3323
US

IV. Provider business mailing address

506 HILL ST
WAYCROSS GA
31501-3323
US

V. Phone/Fax

Practice location:
  • Phone: 912-406-2237
  • Fax: 339-207-0790
Mailing address:
  • Phone: 912-406-2237
  • Fax: 339-207-0790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ERIC SPIRES BELCHER
Title or Position: PHYSICIAN
Credential: MD, AAHIVS
Phone: 912-406-2237