11D0901203 CLIA NUMBER - HILLSIDE

Laboratory Demographics

  • CLIA Code: 11D0901203
  • Facility Name: HILLSIDE
  • Facility Address: 690 COURTENAY DRIVE, NE
    ATLANTA, GA
    ZIP 30306
  • Facility Phone: 404 875-4551
  • Facility Type: Other - PSYCHIATRIC REDISENTIAL
  • Facility Type: Microscopy
  • Lab Director: DR. RANA SIBAI-DRAKE
  • NPI Number: 1023219284
  • Taxonomy: 323P00000X - Psychiatric Residential Treatment Facility

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CLIA Record

Field Name Field Value
CLIA Number 11D0901203
LAB Type Other - PSYCHIATRIC REDISENTIAL
Facility Name HILLSIDE
Street 690 COURTENAY DRIVE, NE
City ATLANTA
State GA
ZIP 30306
Phone 404 875-4551
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 5/18/2025
Certificate Expiration Date 5/17/2027
Facility Type Other - PSYCHIATRIC REDISENTIAL
Lab Director DR. RANA SIBAI-DRAKE

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