11D2051672 CLIA NUMBER - PALMS AT LAKE SPIVEY, THE

Laboratory Demographics

  • CLIA Code: 11D2051672
  • Facility Name: PALMS AT LAKE SPIVEY, THE
  • Facility Address: 8080 SUMMIT BUSINESS PARKWAY
    JONESBORO, GA
    ZIP 30236
  • Facility Phone: 770 477-7207
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MS. TIFFANY LOREN AMEY
  • NPI Number: 1770866519
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 11D2051672
LAB Type Assisted Living Facility
Facility Name PALMS AT LAKE SPIVEY, THE
Street 8080 SUMMIT BUSINESS PARKWAY
City JONESBORO
State GA
ZIP 30236
Phone 770 477-7207
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/26/2024
Certificate Expiration Date 12/25/2026
Facility Type Assisted Living Facility
Lab Director MS. TIFFANY LOREN AMEY

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