11D2132508 CLIA NUMBER - GIFT TRANSITIONAL HOME, INC

Laboratory Demographics

  • CLIA Code: 11D2132508
  • Facility Name: GIFT TRANSITIONAL HOME, INC
  • Facility Address: 5536 OLD NATIONAL HIGHWAY, SUITE 150
    COLLEGE PARK, GA
    ZIP 30349
  • Facility Phone: 404 564-6486
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: ANANABA A. GODWIN
  • NPI Number: 1659874493
  • Taxonomy: 251B00000X - Case Management

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2132508
LAB Type Community Clinic
Facility Name GIFT TRANSITIONAL HOME, INC
Street 5536 OLD NATIONAL HIGHWAY, SUITE 150
City COLLEGE PARK
State GA
ZIP 30349
Phone 404 564-6486
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/21/2023
Certificate Expiration Date 6/20/2025
Facility Type Community Clinic
Lab Director ANANABA A. GODWIN

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: 6/4/2025