11D1028074 CLIA NUMBER - CLAYTON STATE UNIVERSITY UNIVERSITY HEALTH SERVICES

Laboratory Demographics

  • CLIA Code: 11D1028074
  • Facility Name: CLAYTON STATE UNIVERSITY UNIVERSITY HEALTH SERVICES
  • Facility Address: 2000 CLAYTON STATE BOULEVARD
    MORROW, GA
    ZIP 30260
  • Facility Phone: 678 466-4940
  • Facility Type: School/Student Health Service
  • Facility Type: Waiver
  • Lab Director: JENNILY SIMMONS
  • NPI Number: 1659758985
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 11D1028074
LAB Type School/Student Health Service
Facility Name CLAYTON STATE UNIVERSITY UNIVERSITY HEALTH SERVICES
Street 2000 CLAYTON STATE BOULEVARD
City MORROW
State GA
ZIP 30260
Phone 678 466-4940
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/20/2024
Certificate Expiration Date 7/19/2026
Facility Type School/Student Health Service
Lab Director JENNILY SIMMONS

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