11D2161565 CLIA NUMBER - GENESIS COMPREHENSIVE WELLNESS SCREENINGS, LLC

Laboratory Demographics

  • CLIA Code: 11D2161565
  • Facility Name: GENESIS COMPREHENSIVE WELLNESS SCREENINGS, LLC
  • Facility Address: 3417 HIGHWAY 5, C-1
    DOUGLASVILLE, GA
    ZIP 30135
  • Facility Phone: 770 742-8846
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: JANINE T. EASTMAN
  • NPI Number: 1366035768
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2161565
LAB Type Mobile Laboratory
Facility Name GENESIS COMPREHENSIVE WELLNESS SCREENINGS, LLC
Street 3417 HIGHWAY 5, C-1
City DOUGLASVILLE
State GA
ZIP 30135
Phone 770 742-8846
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/6/2025
Certificate Expiration Date 2/5/2027
Facility Type Mobile Laboratory
Lab Director JANINE T. EASTMAN

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