11D2284469 CLIA NUMBER - CLINICA VITAL, LLC

Laboratory Demographics

  • CLIA Code: 11D2284469
  • Facility Name: CLINICA VITAL, LLC
  • Facility Address: 3661 CLAIRMONT ROAD
    CHAMBLEE, GA
    ZIP 30341
  • Facility Phone: 770 797-5167
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOSE A. BATISTA
  • NPI Number: 1780374645
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2284469
LAB Type Physician Office
Facility Name CLINICA VITAL, LLC
Street 3661 CLAIRMONT ROAD
City CHAMBLEE
State GA
ZIP 30341
Phone 770 797-5167
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/23/2025
Certificate Expiration Date 6/22/2027
Facility Type Physician Office
Lab Director JOSE A. BATISTA

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