MEDICARE: CLINICAL DIAGNOSTIC SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1154202810
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLINICAL DIAGNOSTIC SERVICES, LLC

Provider Business Mailing Address
First Line	:	506 HILL ST
Second Line	:
City	:	WAYCROSS
State	:	GA
Zip	:	31501-3323
Country	:	US
Telephone Number	:	912-406-2237
Fax Number	:	339-207-0790

Provider Business Practice Location Address
First Line	:	506 HILL ST
Second Line	:
City	:	WAYCROSS
State	:	GA
Zip	:	31501-3323
Country	:	US
Telephone Number	:	912-406-2237
Fax Number	:	339-207-0790

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. ERIC SPIRES BELCHER
Credential	:	MD, AAHIVS
Telephone Number	:	912-406-2237

Provider Enumeration Date	:	09/09/2025
Last Update Date	:	12/19/2025

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