11D2099169 CLIA NUMBER - SOVEREIGN HOSPICE, INC

Laboratory Demographics

  • CLIA Code: 11D2099169
  • Facility Name: SOVEREIGN HOSPICE, INC
  • Facility Address: 6065 ROSWELL ROAD, SUITE 520
    SANDY SPRINGS, GA
    ZIP 30328
  • Facility Phone: 470 223-3773
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: ENID WRIGHT
  • NPI Number: 1548678923
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 11D2099169
LAB Type Hospice
Facility Name SOVEREIGN HOSPICE, INC
Street 6065 ROSWELL ROAD, SUITE 520
City SANDY SPRINGS
State GA
ZIP 30328
Phone 470 223-3773
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/21/2025
Certificate Expiration Date 7/20/2027
Facility Type Hospice
Lab Director ENID WRIGHT

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