11D0985487 CLIA NUMBER - HIGHLAND RIVERS COMMUNITY SERVICE BOARD

Laboratory Demographics

  • CLIA Code: 11D0985487
  • Facility Name: HIGHLAND RIVERS COMMUNITY SERVICE BOARD
  • Facility Address: 1503 N TIBBS ROAD
    DALTON, GA
    ZIP 30720
  • Facility Phone: 706 270-5000
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: FRANCISCA I. MGBODILE
  • NPI Number: 1417010885
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 11D0985487
LAB Type Community Clinic
Facility Name HIGHLAND RIVERS COMMUNITY SERVICE BOARD
Street 1503 N TIBBS ROAD
City DALTON
State GA
ZIP 30720
Phone 706 270-5000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/20/2025
Certificate Expiration Date 4/19/2027
Facility Type Community Clinic
Lab Director FRANCISCA I. MGBODILE

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