11D0961276 CLIA NUMBER - MEDSIDE HOME HEALTH AGENCY

Laboratory Demographics

  • CLIA Code: 11D0961276
  • Facility Name: MEDSIDE HOME HEALTH AGENCY
  • Facility Address: 1120 HOPE RD
    SANDY SPRINGS, GA
    ZIP 30350
  • Facility Phone: 404 633-7433
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: VICTOR VAYSMAN
  • NPI Number: 1689790867
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 11D0961276
LAB Type Home Health Agency
Facility Name MEDSIDE HOME HEALTH AGENCY
Street 1120 HOPE RD
City SANDY SPRINGS
State GA
ZIP 30350
Phone 404 633-7433
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/2/2025
Certificate Expiration Date 6/1/2027
Facility Type Home Health Agency
Lab Director VICTOR VAYSMAN

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