11D2245662 CLIA NUMBER - DOUGLAS COUNTY COMMUNITY SERVICE BOARD

Laboratory Demographics

  • CLIA Code: 11D2245662
  • Facility Name: DOUGLAS COUNTY COMMUNITY SERVICE BOARD
  • Facility Address: 5905 STEWART PARKWAY
    DOUGLASVILLE, GA
    ZIP 30135
  • Facility Phone: 770 949-8082
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: DR. EDWARD AJAYI
  • NPI Number: 1427198878
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 11D2245662
LAB Type Community Clinic
Facility Name DOUGLAS COUNTY COMMUNITY SERVICE BOARD
Street 5905 STEWART PARKWAY
City DOUGLASVILLE
State GA
ZIP 30135
Phone 770 949-8082
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 Community Clinic
Lab Director DR. EDWARD AJAYI

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