11D2226419 CLIA NUMBER - EQUITY ADVANCED NURSING AND WELLNESS SERVICES, LLC

Laboratory Demographics

  • CLIA Code: 11D2226419
  • Facility Name: EQUITY ADVANCED NURSING AND WELLNESS SERVICES, LLC
  • Facility Address: 961 NORTH CHEROKEE ROAD, SUITE A
    SOCIAL CIRCLE, GA
    ZIP 30025
  • Facility Phone: 770 910-0441
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: MARILYN E. WHITENING
  • NPI Number: 1356925127
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 11D2226419
LAB Type Practitioner Other
Facility Name EQUITY ADVANCED NURSING AND WELLNESS SERVICES, LLC
Street 961 NORTH CHEROKEE ROAD, SUITE A
City SOCIAL CIRCLE
State GA
ZIP 30025
Phone 770 910-0441
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/1/2025
Certificate Expiration Date 5/31/2027
Facility Type Practitioner Other
Lab Director MARILYN E. WHITENING

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