11D2284281 CLIA NUMBER - APTIVE DIAGNOSTICS LLC

Laboratory Demographics

  • CLIA Code: 11D2284281
  • Facility Name: APTIVE DIAGNOSTICS LLC
  • Facility Address: 5442 FRONTAGE ROAD, SUITE 130
    FOREST PARK, GA
    ZIP 30297
  • Facility Phone: 346 466-8700
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: LE ANTHONY A. HARDY
  • NPI Number: 1932867355
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 11D2284281
LAB Type Mobile Laboratory
Facility Name APTIVE DIAGNOSTICS LLC
Street 5442 FRONTAGE ROAD, SUITE 130
City FOREST PARK
State GA
ZIP 30297
Phone 346 466-8700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/21/2025
Certificate Expiration Date 6/20/2027
Facility Type Mobile Laboratory
Lab Director LE ANTHONY A. HARDY

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