11D2240968 CLIA NUMBER - BLESSED HANDS MOBILE LAB

Laboratory Demographics

  • CLIA Code: 11D2240968
  • Facility Name: BLESSED HANDS MOBILE LAB
  • Facility Address: 320 W LANIER AVENUE SUITE 200
    FAYETTEVILLE, GA
    ZIP 30214
  • Facility Phone: 678 696-7896
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: SHIRLEY J. SOLOMON
  • NPI Number: 1417608522
  • Taxonomy: 246RM2200X - Technician, Pathology

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CLIA Record

Field Name Field Value
CLIA Number 11D2240968
LAB Type Mobile Laboratory
Facility Name BLESSED HANDS MOBILE LAB
Street 320 W LANIER AVENUE SUITE 200
City FAYETTEVILLE
State GA
ZIP 30214
Phone 678 696-7896
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/25/2023
Certificate Expiration Date 10/24/2025
Facility Type Mobile Laboratory
Lab Director SHIRLEY J. SOLOMON

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