11D2106445 CLIA NUMBER - GREENLEE BEHAVIORAL HEALTH SERVICES

Laboratory Demographics

  • CLIA Code: 11D2106445
  • Facility Name: GREENLEE BEHAVIORAL HEALTH SERVICES
  • Facility Address: 778 RAYS ROAD, SUITE 102
    STONE MOUNTAIN, GA
    ZIP 30083
  • Facility Phone: 404 298-1230
  • Facility Type: Other - IFI CORE PROVIDER
  • Facility Type: Waiver
  • Lab Director: ELIZABETH FRAZIER
  • NPI Number: 1881968584
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 11D2106445
LAB Type Other - IFI CORE PROVIDER
Facility Name GREENLEE BEHAVIORAL HEALTH SERVICES
Street 778 RAYS ROAD, SUITE 102
City STONE MOUNTAIN
State GA
ZIP 30083
Phone 404 298-1230
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/18/2023
Certificate Expiration Date 12/17/2025
Facility Type Other - IFI CORE PROVIDER
Lab Director ELIZABETH FRAZIER

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This page was last updated on: 3/20/2025