11D2129949 CLIA NUMBER - SOUTHEAST ATLANTA VASCULAR CARE, LLC

Laboratory Demographics

  • CLIA Code: 11D2129949
  • Facility Name: SOUTHEAST ATLANTA VASCULAR CARE, LLC
  • Facility Address: 5461 HILLANDALE DRIVE, SUITE 210
    LITHONIA, GA
    ZIP 30058
  • Facility Phone: 770 981-8477
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. SANDEEP SHARMA
  • NPI Number: 1922549237
  • Taxonomy: 2086S0129X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 11D2129949
LAB Type Physician Office
Facility Name SOUTHEAST ATLANTA VASCULAR CARE, LLC
Street 5461 HILLANDALE DRIVE, SUITE 210
City LITHONIA
State GA
ZIP 30058
Phone 770 981-8477
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/28/2025
Certificate Expiration Date 4/27/2027
Facility Type Physician Office
Lab Director DR. SANDEEP SHARMA

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