11D0257427 CLIA NUMBER - HEALTHY STAGES PEDIATRICS

Laboratory Demographics

  • CLIA Code: 11D0257427
  • Facility Name: HEALTHY STAGES PEDIATRICS
  • Facility Address: 1115 MOUNT ZION ROAD SUITE E
    MORROW, GA
    ZIP 30260
  • Facility Phone: 770 960-9999
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NAIOMI M. SHOCKLEY
  • NPI Number: 1821496241
  • Taxonomy: 363LP0200X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 11D0257427
LAB Type Physician Office
Facility Name HEALTHY STAGES PEDIATRICS
Street 1115 MOUNT ZION ROAD SUITE E
City MORROW
State GA
ZIP 30260
Phone 770 960-9999
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director NAIOMI M. SHOCKLEY

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