11D2284292 CLIA NUMBER - BLUE SUMMIT HOSPICE & PALLIATIVE CARE OF ROSWELL

Laboratory Demographics

  • CLIA Code: 11D2284292
  • Facility Name: BLUE SUMMIT HOSPICE & PALLIATIVE CARE OF ROSWELL
  • Facility Address: 11113 HOUZE ROAD
    ROSWELL, GA
    ZIP 30076
  • Facility Phone: 470 289-0074
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: AMANDA DELPOZO MCKISSICK
  • NPI Number: 1841017985
  • Taxonomy: 251B00000X - Case Management

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CLIA Record

Field Name Field Value
CLIA Number 11D2284292
LAB Type Hospice
Facility Name BLUE SUMMIT HOSPICE & PALLIATIVE CARE OF ROSWELL
Street 11113 HOUZE ROAD
City ROSWELL
State GA
ZIP 30076
Phone 470 289-0074
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 Hospice
Lab Director AMANDA DELPOZO MCKISSICK

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