11D2285156 CLIA NUMBER - PURPLE HEARTS EMS

Laboratory Demographics

  • CLIA Code: 11D2285156
  • Facility Name: PURPLE HEARTS EMS
  • Facility Address: 1700 PENNSYLVANIA AVENUE #109
    MCDONOUGH, GA
    ZIP 30253
  • Facility Phone: 678 978-4855
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: CHIVON STUBBS
  • NPI Number: 1770253684
  • Taxonomy: 343900000X - Non-emergency Medical Transport (VAN)

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CLIA Record

Field Name Field Value
CLIA Number 11D2285156
LAB Type Ambulance
Facility Name PURPLE HEARTS EMS
Street 1700 PENNSYLVANIA AVENUE #109
City MCDONOUGH
State GA
ZIP 30253
Phone 678 978-4855
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/7/2025
Certificate Expiration Date 7/6/2027
Facility Type Ambulance
Lab Director CHIVON STUBBS

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