11D2195353 CLIA NUMBER - ANGEL HEART HOSPICE DBA FAMILY HOSPICE

Laboratory Demographics

  • CLIA Code: 11D2195353
  • Facility Name: ANGEL HEART HOSPICE DBA FAMILY HOSPICE
  • Facility Address: 435 WEST BANKHEAD HWY
    VILLA RICA, GA
    ZIP 30180
  • Facility Phone: 800 410-4663
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: ROBIN STANTON
  • NPI Number: 1700402443
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 11D2195353
LAB Type Hospice
Facility Name ANGEL HEART HOSPICE DBA FAMILY HOSPICE
Street 435 WEST BANKHEAD HWY
City VILLA RICA
State GA
ZIP 30180
Phone 800 410-4663
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/8/2024
Certificate Expiration Date 10/7/2026
Facility Type Hospice
Lab Director ROBIN STANTON

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