11D2250828 CLIA NUMBER - GRANDS PREMIER HEALTH & LAB DIAGNOSTICS, LLC

Laboratory Demographics

  • CLIA Code: 11D2250828
  • Facility Name: GRANDS PREMIER HEALTH & LAB DIAGNOSTICS, LLC
  • Facility Address: 3347 SURVEYOR COURT
    DOUGLASVILLE, GA
    ZIP 30135
  • Facility Phone: 770 990-4699
  • Facility Type: Other - DIAGNOSTIC TEST FAC
  • Facility Type: Waiver
  • Lab Director: SHANTEL A. BROWN
  • NPI Number: 1184376931
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2250828
LAB Type Other - DIAGNOSTIC TEST FAC
Facility Name GRANDS PREMIER HEALTH & LAB DIAGNOSTICS, LLC
Street 3347 SURVEYOR COURT
City DOUGLASVILLE
State GA
ZIP 30135
Phone 770 990-4699
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/30/2024
Certificate Expiration Date 1/29/2026
Facility Type Other - DIAGNOSTIC TEST FAC
Lab Director SHANTEL A. BROWN

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