11D0021448 CLIA NUMBER - MOUNTAIN LAKES MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 11D0021448
  • Facility Name: MOUNTAIN LAKES MEDICAL CENTER
  • Facility Address: 162 LEGACY POINT ATTN ANASTASIA PALOWITZ
    CLAYTON, GA
    ZIP 30525
  • Facility Phone: 864 557-5269
  • Facility Type: Hospital
  • Facility Type: Certificate of Compliance
  • Lab Director: JOSEPH J. GAINES
  • NPI Number: 1932220266
  • Taxonomy: 225100000X - Physical Therapist

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CLIA Record

Field Name Field Value
CLIA Number 11D0021448
LAB Type Hospital
Facility Name MOUNTAIN LAKES MEDICAL CENTER
Street 162 LEGACY POINT ATTN ANASTASIA PALOWITZ
City CLAYTON
State GA
ZIP 30525
Phone 864 557-5269
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 3/25/2024
Certificate Expiration Date 3/24/2026
Facility Type Hospital
Lab Director JOSEPH J. GAINES

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This page was last updated on: 9/29/2025