11D2219437 CLIA NUMBER - CLEAVER MEDICAL GROUP ASC

Laboratory Demographics

  • CLIA Code: 11D2219437
  • Facility Name: CLEAVER MEDICAL GROUP ASC
  • Facility Address: 105 PROFESSIONAL PARK DRIVE, SUITE 102
    CUMMING, GA
    ZIP 30040
  • Facility Phone: 770 800-3455
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MIRANDA L. REED
  • NPI Number: 1164093068
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2219437
LAB Type Ambulatory Surgery Center
Facility Name CLEAVER MEDICAL GROUP ASC
Street 105 PROFESSIONAL PARK DRIVE, SUITE 102
City CUMMING
State GA
ZIP 30040
Phone 770 800-3455
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/6/2025
Certificate Expiration Date 4/5/2027
Facility Type Ambulatory Surgery Center
Lab Director MIRANDA L. REED

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