11D0995408 CLIA NUMBER - BALL PEDIATRICS

Laboratory Demographics

  • CLIA Code: 11D0995408
  • Facility Name: BALL PEDIATRICS
  • Facility Address: 3619 BRASELTON HIGHWAY SUITE 103
    DACULA, GA
    ZIP 30019
  • Facility Phone: 770 513-8882
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ASHLEY N. SIPSY
  • NPI Number: 1417194218
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D0995408
LAB Type Physician Office
Facility Name BALL PEDIATRICS
Street 3619 BRASELTON HIGHWAY SUITE 103
City DACULA
State GA
ZIP 30019
Phone 770 513-8882
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/18/2024
Certificate Expiration Date 1/17/2026
Facility Type Physician Office
Lab Director ASHLEY N. SIPSY

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