11D2275784 CLIA NUMBER - SKYLINE EMS

Laboratory Demographics

  • CLIA Code: 11D2275784
  • Facility Name: SKYLINE EMS
  • Facility Address: 1549 EAST CHURCH STREET
    JASPER, GA
    ZIP 30143
  • Facility Phone: 770 880-0161
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: PAUL HENDERSON
  • NPI Number: 1881162451
  • Taxonomy: 341600000X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 11D2275784
LAB Type Ambulance
Facility Name SKYLINE EMS
Street 1549 EAST CHURCH STREET
City JASPER
State GA
ZIP 30143
Phone 770 880-0161
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/27/2025
Certificate Expiration Date 1/26/2027
Facility Type Ambulance
Lab Director PAUL HENDERSON

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