11D0703829 CLIA NUMBER - EAST LAKE ARBOR

Laboratory Demographics

  • CLIA Code: 11D0703829
  • Facility Name: EAST LAKE ARBOR
  • Facility Address: 304 FIFTH AVE
    DECATUR, GA
    ZIP 30030
  • Facility Phone: 404 373-6231
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ANDREW FRINKS
  • NPI Number: 1265963144
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 11D0703829
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name EAST LAKE ARBOR
Street 304 FIFTH AVE
City DECATUR
State GA
ZIP 30030
Phone 404 373-6231
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 Skilled Nursing Facility/Nursing Facility
Lab Director ANDREW FRINKS

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