11D1078956 CLIA NUMBER - AMEDISYS HOSPICE CARE OF KENNESAW

Laboratory Demographics

  • CLIA Code: 11D1078956
  • Facility Name: AMEDISYS HOSPICE CARE OF KENNESAW
  • Facility Address: 4425 WADE GREEN RD NW, BLDG 300, SUITE 320
    KENNESAW, GA
    ZIP 30144
  • Facility Phone: 770 423-1316
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: DANIELLE CIMBA
  • NPI Number: 1396938015
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 11D1078956
LAB Type Hospice
Facility Name AMEDISYS HOSPICE CARE OF KENNESAW
Street 4425 WADE GREEN RD NW, BLDG 300, SUITE 320
City KENNESAW
State GA
ZIP 30144
Phone 770 423-1316
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/18/2024
Certificate Expiration Date 1/17/2026
Facility Type Hospice
Lab Director DANIELLE CIMBA

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