11D2202150 CLIA NUMBER - MEDSTAR EMS, LLC

Laboratory Demographics

  • CLIA Code: 11D2202150
  • Facility Name: MEDSTAR EMS, LLC
  • Facility Address: 1375 PRITCHETT INDUSTRIAL BOULEVARD
    AUSTELL, GA
    ZIP 30168
  • Facility Phone: 770 693-2291
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: GLEN F. VANN
  • NPI Number: 1467916387
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 11D2202150
LAB Type Ambulance
Facility Name MEDSTAR EMS, LLC
Street 1375 PRITCHETT INDUSTRIAL BOULEVARD
City AUSTELL
State GA
ZIP 30168
Phone 770 693-2291
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/25/2024
Certificate Expiration Date 11/24/2026
Facility Type Ambulance
Lab Director GLEN F. VANN

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