11D2257633 CLIA NUMBER - QUALITY HEALTH SOURCE, LLC

Laboratory Demographics

  • CLIA Code: 11D2257633
  • Facility Name: QUALITY HEALTH SOURCE, LLC
  • Facility Address: 6116 MABLETON PARKWAY, SW SUITE 136
    MABLETON, GA
    ZIP 30126
  • Facility Phone: 770 878-2997
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: TEMEKA L. JOHNSON
  • NPI Number: 1780327346
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2257633
LAB Type Practitioner Other
Facility Name QUALITY HEALTH SOURCE, LLC
Street 6116 MABLETON PARKWAY, SW SUITE 136
City MABLETON
State GA
ZIP 30126
Phone 770 878-2997
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/8/2024
Certificate Expiration Date 4/7/2026
Facility Type Practitioner Other
Lab Director TEMEKA L. JOHNSON

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