11D2275172 CLIA NUMBER - PROMED TRANSPORT LLC

Laboratory Demographics

  • CLIA Code: 11D2275172
  • Facility Name: PROMED TRANSPORT LLC
  • Facility Address: 1720 LEXINGTON ROAD, SUITE B
    ATHENS, GA
    ZIP 30605
  • Facility Phone: 770 800-8007
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: NATE DAVOL
  • NPI Number: 1285192781
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 11D2275172
LAB Type Ambulance
Facility Name PROMED TRANSPORT LLC
Street 1720 LEXINGTON ROAD, SUITE B
City ATHENS
State GA
ZIP 30605
Phone 770 800-8007
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/18/2025
Certificate Expiration Date 1/17/2027
Facility Type Ambulance
Lab Director NATE DAVOL

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