11D1025831 CLIA NUMBER - SACRED JOURNEY HOSPICE

Laboratory Demographics

  • CLIA Code: 11D1025831
  • Facility Name: SACRED JOURNEY HOSPICE
  • Facility Address: 138 PEACH DRIVE
    MCDONOUGH, GA
    ZIP 30252
  • Facility Phone: 678 583-0717
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: PETROVNA SYLVESTRE-JONES
  • NPI Number: 1306919683
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 11D1025831
LAB Type Hospice
Facility Name SACRED JOURNEY HOSPICE
Street 138 PEACH DRIVE
City MCDONOUGH
State GA
ZIP 30252
Phone 678 583-0717
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/28/2024
Certificate Expiration Date 11/27/2026
Facility Type Hospice
Lab Director PETROVNA SYLVESTRE-JONES

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