11D1053033 CLIA NUMBER - MESUN HEALTH SERVICES INCORPORATED

Laboratory Demographics

  • CLIA Code: 11D1053033
  • Facility Name: MESUN HEALTH SERVICES INCORPORATED
  • Facility Address: 88 JOHNSON RD
    LAWRENCEVILLE, GA
    ZIP 30046
  • Facility Phone: 770 623-2710
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: JUSTINA ANTILL
  • NPI Number: 1295793446
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 11D1053033
LAB Type Hospice
Facility Name MESUN HEALTH SERVICES INCORPORATED
Street 88 JOHNSON RD
City LAWRENCEVILLE
State GA
ZIP 30046
Phone 770 623-2710
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/23/2025
Certificate Expiration Date 4/22/2027
Facility Type Hospice
Lab Director JUSTINA ANTILL

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