11D2288607 CLIA NUMBER - APPALACHIAN HOSPICE SOUTH, LLC DBA APPALACHIAN HOSPICE

Laboratory Demographics

  • CLIA Code: 11D2288607
  • Facility Name: APPALACHIAN HOSPICE SOUTH, LLC DBA APPALACHIAN HOSPICE
  • Facility Address: 12 SAMMY MCGHEE BLVD, SUITE 202
    JASPER, GA
    ZIP 30143
  • Facility Phone: 706 253-4011
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: GARY W. RASMUSSEN
  • NPI Number: 1063193738
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 11D2288607
LAB Type Hospice
Facility Name APPALACHIAN HOSPICE SOUTH, LLC DBA APPALACHIAN HOSPICE
Street 12 SAMMY MCGHEE BLVD, SUITE 202
City JASPER
State GA
ZIP 30143
Phone 706 253-4011
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/29/2023
Certificate Expiration Date 8/28/2025
Facility Type Hospice
Lab Director GARY W. RASMUSSEN

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This page was last updated on: 3/20/2025