11D2080777 CLIA NUMBER - STELLA MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 11D2080777
  • Facility Name: STELLA MEDICAL CENTER
  • Facility Address: 2121-B FAIRBURN ROAD
    DOUGLASVILLE, GA
    ZIP 30135
  • Facility Phone: 678 594-3881
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CAROLINE C. ANAELE
  • NPI Number: 1558773002
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 11D2080777
LAB Type Physician Office
Facility Name STELLA MEDICAL CENTER
Street 2121-B FAIRBURN ROAD
City DOUGLASVILLE
State GA
ZIP 30135
Phone 678 594-3881
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/15/2024
Certificate Expiration Date 7/14/2026
Facility Type Physician Office
Lab Director CAROLINE C. ANAELE

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