11D2237605 CLIA NUMBER - PROSALUD CENTRO MEDICO LLC

Laboratory Demographics

  • CLIA Code: 11D2237605
  • Facility Name: PROSALUD CENTRO MEDICO LLC
  • Facility Address: 1870 ATLANTA HIGHWAY SUITE J
    GAINESVILLE, GA
    ZIP 30504
  • Facility Phone: 770 534-0670
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANN S. DRAYTON
  • NPI Number: 1124478078
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2237605
LAB Type Physician Office
Facility Name PROSALUD CENTRO MEDICO LLC
Street 1870 ATLANTA HIGHWAY SUITE J
City GAINESVILLE
State GA
ZIP 30504
Phone 770 534-0670
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/27/2025
Certificate Expiration Date 9/26/2027
Facility Type Physician Office
Lab Director ANN S. DRAYTON

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