11D1091870 CLIA NUMBER - ASSURED HOSPICE CARE, LLC DBA GEORGIA HOSPICE CARE

Laboratory Demographics

  • CLIA Code: 11D1091870
  • Facility Name: ASSURED HOSPICE CARE, LLC DBA GEORGIA HOSPICE CARE
  • Facility Address: 4900 IVEY ROAD, SUITE 1405
    ACWORTH, GA
    ZIP 30101
  • Facility Phone: 770 387-9578
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: JENNIFER BEASLEY
  • NPI Number: 1568825909
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 11D1091870
LAB Type Hospice
Facility Name ASSURED HOSPICE CARE, LLC DBA GEORGIA HOSPICE CARE
Street 4900 IVEY ROAD, SUITE 1405
City ACWORTH
State GA
ZIP 30101
Phone 770 387-9578
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/13/2024
Certificate Expiration Date 11/12/2026
Facility Type Hospice
Lab Director JENNIFER BEASLEY

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This page was last updated on: 3/20/2025