11D2245022 CLIA NUMBER - VITAINFUSE THERAPY

Laboratory Demographics

  • CLIA Code: 11D2245022
  • Facility Name: VITAINFUSE THERAPY
  • Facility Address: 6254 MEMORIAL DRIVE, SUITE F
    STONE MOUNTAIN, GA
    ZIP 30083
  • Facility Phone: 770 558-1029
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: ANDREA F. CAESAR
  • NPI Number: 1467183996
  • Taxonomy: 261QM1300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2245022
LAB Type Practitioner Other
Facility Name VITAINFUSE THERAPY
Street 6254 MEMORIAL DRIVE, SUITE F
City STONE MOUNTAIN
State GA
ZIP 30083
Phone 770 558-1029
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/8/2023
Certificate Expiration Date 12/7/2025
Facility Type Practitioner Other
Lab Director ANDREA F. CAESAR

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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