11D0975645 CLIA NUMBER - JASMINE JEFFERS MD LLC, WESTSIDE MED ASSOC

Laboratory Demographics

  • CLIA Code: 11D0975645
  • Facility Name: JASMINE JEFFERS MD LLC, WESTSIDE MED ASSOC
  • Facility Address: 3825 MEDICAL PARK DRIVE, SUITE 300
    AUSTELL, GA
    ZIP 30106
  • Facility Phone: 770 941-4810
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JASMINE G. JEFFERS
  • NPI Number: 1518950617
  • Taxonomy: 207RG0100X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0975645
LAB Type Physician Office
Facility Name JASMINE JEFFERS MD LLC, WESTSIDE MED ASSOC
Street 3825 MEDICAL PARK DRIVE, SUITE 300
City AUSTELL
State GA
ZIP 30106
Phone 770 941-4810
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/18/2025
Certificate Expiration Date 4/17/2027
Facility Type Physician Office
Lab Director JASMINE G. JEFFERS

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