11D2152582 CLIA NUMBER - KES, INC

Laboratory Demographics

CLIA Number: 11D2152582

Facility Name: KES, INC

Facility Address:
6440 OLD HILANDALE DRIVE
LITHONIA, GA
ZIP 30058
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Facility Phone Number: 404 289-7174

Facility Type: Other - BEHAVIORAL HEALTH CLINIC

Certificate Type: Waiver

NPI Number: 1972632693

Taxonomy: 320900000X - Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.

CLIA Record

Field Name	Field Value
CLIA Number	11D2152582
LAB Type	Other - BEHAVIORAL HEALTH CLINIC
Facility Name	KES, INC
Street	6440 OLD HILANDALE DRIVE
City	LITHONIA
State	GA
ZIP	30058
Phone	404 289-7174
CertificateType	4
CertificateEffectiveDate	8/13/2022
CertificateExpirationDate	8/12/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024