11D0925478 CLIA NUMBER - DEVEREUX ADVANCED BEHAVIORAL HEALTH

Laboratory Demographics

  • CLIA Code: 11D0925478
  • Facility Name: DEVEREUX ADVANCED BEHAVIORAL HEALTH
  • Facility Address: 1291 STANLEY ROAD, NW
    KENNESAW, GA
    ZIP 30152
  • Facility Phone: 770 738-2648
  • Facility Type: Other - PRTF AND GROUP HOME
  • Facility Type: Waiver
  • Lab Director: KIMBERLY M. CARRIGG
  • NPI Number: 1073997888
  • Taxonomy: 323P00000X - Psychiatric Residential Treatment Facility

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CLIA Record

Field Name Field Value
CLIA Number 11D0925478
LAB Type Other - PRTF AND GROUP HOME
Facility Name DEVEREUX ADVANCED BEHAVIORAL HEALTH
Street 1291 STANLEY ROAD, NW
City KENNESAW
State GA
ZIP 30152
Phone 770 738-2648
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/23/2025
Certificate Expiration Date 10/22/2027
Facility Type Other - PRTF AND GROUP HOME
Lab Director KIMBERLY M. CARRIGG

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