11D0927310 CLIA NUMBER - DEKALB COMMUNITY SERVICE BOARD

Laboratory Demographics

  • CLIA Code: 11D0927310
  • Facility Name: DEKALB COMMUNITY SERVICE BOARD
  • Facility Address: 445 WINN WAY, 4TH FLOOR
    DECATUR, GA
    ZIP 30030
  • Facility Phone: 404 231-9363
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: CARMEN MARTINEZ
  • NPI Number: 1861536955
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 11D0927310
LAB Type Other
Facility Name DEKALB COMMUNITY SERVICE BOARD
Street 445 WINN WAY, 4TH FLOOR
City DECATUR
State GA
ZIP 30030
Phone 404 231-9363
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/16/2025
Certificate Expiration Date 4/15/2027
Facility Type Other
Lab Director CARMEN MARTINEZ

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