11D2163421 CLIA NUMBER - IMMACULATE HEATLHCARE SOLUTIONS, LLC

Laboratory Demographics

  • CLIA Code: 11D2163421
  • Facility Name: IMMACULATE HEATLHCARE SOLUTIONS, LLC
  • Facility Address: 970 PEACHTREE INDUSTRIAL BOULEVARD, SUITE 8
    SUWANEE, GA
    ZIP 30024
  • Facility Phone: 678 707-2369
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: IJEH O. TIMOTHY
  • NPI Number: 1740778463
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 11D2163421
LAB Type Home Health Agency
Facility Name IMMACULATE HEATLHCARE SOLUTIONS, LLC
Street 970 PEACHTREE INDUSTRIAL BOULEVARD, SUITE 8
City SUWANEE
State GA
ZIP 30024
Phone 678 707-2369
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/14/2025
Certificate Expiration Date 3/13/2027
Facility Type Home Health Agency
Lab Director IJEH O. TIMOTHY

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