11D2220489 CLIA NUMBER - HOPE CLINICAL RESEARCH AND WELLNESS

Laboratory Demographics

  • CLIA Code: 11D2220489
  • Facility Name: HOPE CLINICAL RESEARCH AND WELLNESS
  • Facility Address: 992 EAST FREEWAY DRIVE SE SUITE B
    CONYERS, GA
    ZIP 30094
  • Facility Phone: 770 679-5591
  • Facility Type: Other - CLINICAL RESEARCH
  • Facility Type: Waiver
  • Lab Director: BONCILLE MATTOX
  • NPI Number: 1003484403
  • Taxonomy: 364S00000X - Clinical Nurse Specialist

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CLIA Record

Field Name Field Value
CLIA Number 11D2220489
LAB Type Other - CLINICAL RESEARCH
Facility Name HOPE CLINICAL RESEARCH AND WELLNESS
Street 992 EAST FREEWAY DRIVE SE SUITE B
City CONYERS
State GA
ZIP 30094
Phone 770 679-5591
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/13/2025
Certificate Expiration Date 4/12/2027
Facility Type Other - CLINICAL RESEARCH
Lab Director BONCILLE MATTOX

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