11D0965392 CLIA NUMBER - TANNER MEDICAL CENTER HOSPICE CARE INC

Laboratory Demographics

  • CLIA Code: 11D0965392
  • Facility Name: TANNER MEDICAL CENTER HOSPICE CARE INC
  • Facility Address: 705 DIXIE STREET
    CARROLLTON, GA
    ZIP 30117
  • Facility Phone: 770 214-2355
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: DEBORAH K. ALLEN
  • NPI Number: 1396979787
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0965392
LAB Type Hospice
Facility Name TANNER MEDICAL CENTER HOSPICE CARE INC
Street 705 DIXIE STREET
City CARROLLTON
State GA
ZIP 30117
Phone 770 214-2355
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/21/2025
Certificate Expiration Date 9/20/2027
Facility Type Hospice
Lab Director DEBORAH K. ALLEN

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