11D2029372 CLIA NUMBER - WELLSTAR COMMUNITY HOSPICE

Laboratory Demographics

  • CLIA Code: 11D2029372
  • Facility Name: WELLSTAR COMMUNITY HOSPICE
  • Facility Address: 4040 HOSPITAL WEST DRIVE
    AUSTELL, GA
    ZIP 30106
  • Facility Phone: 770 732-6710
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: ALISON KRAUSE
  • NPI Number: 1407811060
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 11D2029372
LAB Type Hospice
Facility Name WELLSTAR COMMUNITY HOSPICE
Street 4040 HOSPITAL WEST DRIVE
City AUSTELL
State GA
ZIP 30106
Phone 770 732-6710
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/7/2025
Certificate Expiration Date 9/6/2027
Facility Type Hospice
Lab Director ALISON KRAUSE

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