11D2243867 CLIA NUMBER - 1ST CLASS AMBULANCE

Laboratory Demographics

  • CLIA Code: 11D2243867
  • Facility Name: 1ST CLASS AMBULANCE
  • Facility Address: 175 WALTER WAY SUITE B
    FAYETTEVILLE, GA
    ZIP 30214
  • Facility Phone: 404 392-0108
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: DWAYNE BROWN
  • NPI Number: 1750908372
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 11D2243867
LAB Type Ambulance
Facility Name 1ST CLASS AMBULANCE
Street 175 WALTER WAY SUITE B
City FAYETTEVILLE
State GA
ZIP 30214
Phone 404 392-0108
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/23/2023
Certificate Expiration Date 11/22/2025
Facility Type Ambulance
Lab Director DWAYNE BROWN

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