11D2283639 CLIA NUMBER - DIVINE DESIGN HOME CARE SERVICES, LLC

Laboratory Demographics

  • CLIA Code: 11D2283639
  • Facility Name: DIVINE DESIGN HOME CARE SERVICES, LLC
  • Facility Address: 1572 HIGHWAY 85 NORTH, SUITE 510
    FAYETTEVILLE, GA
    ZIP 30214
  • Facility Phone: 770 703-3224
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: LASHUNDA WARD
  • NPI Number: 1649957093
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 11D2283639
LAB Type Independent
Facility Name DIVINE DESIGN HOME CARE SERVICES, LLC
Street 1572 HIGHWAY 85 NORTH, SUITE 510
City FAYETTEVILLE
State GA
ZIP 30214
Phone 770 703-3224
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/12/2025
Certificate Expiration Date 6/11/2027
Facility Type Independent
Lab Director LASHUNDA WARD

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