11D2240773 CLIA NUMBER - LIFE STAT EMS, LLC

Laboratory Demographics

  • CLIA Code: 11D2240773
  • Facility Name: LIFE STAT EMS, LLC
  • Facility Address: 3551 BALL GROUND HIGHWAY
    CANTON, GA
    ZIP 30114
  • Facility Phone: 404 987-6278
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: HOWELL GENTRY
  • NPI Number: 1942962048
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 11D2240773
LAB Type Ambulance
Facility Name LIFE STAT EMS, LLC
Street 3551 BALL GROUND HIGHWAY
City CANTON
State GA
ZIP 30114
Phone 404 987-6278
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/22/2023
Certificate Expiration Date 10/21/2025
Facility Type Ambulance
Lab Director HOWELL GENTRY

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