11D1056959 CLIA NUMBER - COMPASSUS -FAYETTEVILLE

Laboratory Demographics

  • CLIA Code: 11D1056959
  • Facility Name: COMPASSUS -FAYETTEVILLE
  • Facility Address: 101 YORKTOWN DRIVE SUITE 107A
    FAYETTEVILLE, GA
    ZIP 30214
  • Facility Phone: 678 817-4180
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: NORA GIBSON
  • NPI Number: 1508882937
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 11D1056959
LAB Type Hospice
Facility Name COMPASSUS -FAYETTEVILLE
Street 101 YORKTOWN DRIVE SUITE 107A
City FAYETTEVILLE
State GA
ZIP 30214
Phone 678 817-4180
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/31/2024
Certificate Expiration Date 7/30/2026
Facility Type Hospice
Lab Director NORA GIBSON

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