11D2273785 CLIA NUMBER - NICELY HEALTH SERVICES, LLC

Laboratory Demographics

  • CLIA Code: 11D2273785
  • Facility Name: NICELY HEALTH SERVICES, LLC
  • Facility Address: 1599 SCHOOL HOUSE RUN
    DACULA, GA
    ZIP 30019
  • Facility Phone: 706 308-5012
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: ANTHONY ASONG
  • NPI Number: 1992430292
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 11D2273785
LAB Type Home Health Agency
Facility Name NICELY HEALTH SERVICES, LLC
Street 1599 SCHOOL HOUSE RUN
City DACULA
State GA
ZIP 30019
Phone 706 308-5012
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/20/2024
Certificate Expiration Date 12/19/2026
Facility Type Home Health Agency
Lab Director ANTHONY ASONG

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