11D1066154 CLIA NUMBER - ANIZ INCORPORATE

Laboratory Demographics

  • CLIA Code: 11D1066154
  • Facility Name: ANIZ INCORPORATE
  • Facility Address: 236 FORSYH STREET, SW, SUITE 300
    ATLANTA, GA
    ZIP 30303
  • Facility Phone: 404 521-2410
  • Facility Type: Other - CBO
  • Facility Type: Waiver
  • Lab Director: ZINA M. AGE
  • NPI Number: 1952724809
  • Taxonomy: 101YM0800X - Counselor

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CLIA Record

Field Name Field Value
CLIA Number 11D1066154
LAB Type Other - CBO
Facility Name ANIZ INCORPORATE
Street 236 FORSYH STREET, SW, SUITE 300
City ATLANTA
State GA
ZIP 30303
Phone 404 521-2410
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/27/2024
Certificate Expiration Date 8/26/2026
Facility Type Other - CBO
Lab Director ZINA M. AGE

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