11D2087813 CLIA NUMBER - NORTHSIDE HOSPITAL INC GCS/JASPER

Laboratory Demographics

  • CLIA Code: 11D2087813
  • Facility Name: NORTHSIDE HOSPITAL INC GCS/JASPER
  • Facility Address: 135 MOUNTAINSIDE VILLAGE PARKWAY, SUITE 100
    JASPER, GA
    ZIP 30143
  • Facility Phone: 706 253-3100
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: YI DONG
  • NPI Number: 1740355338
  • Taxonomy: 208600000X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 11D2087813
LAB Type Physician Office
Facility Name NORTHSIDE HOSPITAL INC GCS/JASPER
Street 135 MOUNTAINSIDE VILLAGE PARKWAY, SUITE 100
City JASPER
State GA
ZIP 30143
Phone 706 253-3100
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 4/29/2025
Certificate Expiration Date 4/28/2027
Facility Type Physician Office
Lab Director YI DONG

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