11D2258963 CLIA NUMBER - PEACH STATE EMS, LLC

Laboratory Demographics

  • CLIA Code: 11D2258963
  • Facility Name: PEACH STATE EMS, LLC
  • Facility Address: 122 AMY INDUSTRIAL LANE
    HOSCHTON, GA
    ZIP 30548
  • Facility Phone: 888 838-1391
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: MICHELLE F. STANCLIFF
  • NPI Number: 1184037616
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 11D2258963
LAB Type Ambulance
Facility Name PEACH STATE EMS, LLC
Street 122 AMY INDUSTRIAL LANE
City HOSCHTON
State GA
ZIP 30548
Phone 888 838-1391
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/29/2024
Certificate Expiration Date 4/28/2026
Facility Type Ambulance
Lab Director MICHELLE F. STANCLIFF

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