11D2245620 CLIA NUMBER - E-SQUARED LAB, LLC

Laboratory Demographics

  • CLIA Code: 11D2245620
  • Facility Name: E-SQUARED LAB, LLC
  • Facility Address: 1540 HIGHWAY 138 SE SUITE 4M
    CONYERS, GA
    ZIP 30013
  • Facility Phone: 404 368-2322
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: SHANETTA ATKINS
  • NPI Number: 1609537265
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 11D2245620
LAB Type Mobile Laboratory
Facility Name E-SQUARED LAB, LLC
Street 1540 HIGHWAY 138 SE SUITE 4M
City CONYERS
State GA
ZIP 30013
Phone 404 368-2322
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/15/2023
Certificate Expiration Date 12/14/2025
Facility Type Mobile Laboratory
Lab Director SHANETTA ATKINS

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