11D2276510 CLIA NUMBER - WEST GEORGIA WELLNESS CENTER

Laboratory Demographics

  • CLIA Code: 11D2276510
  • Facility Name: WEST GEORGIA WELLNESS CENTER
  • Facility Address: 126 ENTERPRISE PATH, SUITE 104B
    HIRAM, GA
    ZIP 30141
  • Facility Phone: 404 444-6228
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: JOSHUA YAGER
  • NPI Number: 1902002546
  • Taxonomy: 2471C3402X - Radiologic Technologist

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CLIA Record

Field Name Field Value
CLIA Number 11D2276510
LAB Type Comp. Outpatient Rehab Facility
Facility Name WEST GEORGIA WELLNESS CENTER
Street 126 ENTERPRISE PATH, SUITE 104B
City HIRAM
State GA
ZIP 30141
Phone 404 444-6228
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/9/2025
Certificate Expiration Date 2/8/2027
Facility Type Comp. Outpatient Rehab Facility
Lab Director JOSHUA YAGER

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