11D2128231 CLIA NUMBER - NORTHSIDE HEART - CANTON

Laboratory Demographics

  • CLIA Code: 11D2128231
  • Facility Name: NORTHSIDE HEART - CANTON
  • Facility Address: 460 NORTHSIDE CHEROKEE BLVD, SUITE 150
    CANTON, GA
    ZIP 30115
  • Facility Phone: 470 639-6250
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DESAI AASHISH
  • NPI Number: 1578789764
  • Taxonomy: 111N00000X - Chiropractor

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2128231
LAB Type Physician Office
Facility Name NORTHSIDE HEART - CANTON
Street 460 NORTHSIDE CHEROKEE BLVD, SUITE 150
City CANTON
State GA
ZIP 30115
Phone 470 639-6250
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/28/2025
Certificate Expiration Date 3/27/2027
Facility Type Physician Office
Lab Director DESAI AASHISH

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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