11D2296667 CLIA NUMBER - COMMUNITY CARE EMS LLC

Laboratory Demographics

  • CLIA Code: 11D2296667
  • Facility Name: COMMUNITY CARE EMS LLC
  • Facility Address: 1939 SR-155 SOUTH, SUITE B
    MCDONOUGH, GA
    ZIP 30253
  • Facility Phone: 770 873-2012
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: JOHNSON RUSSELL
  • NPI Number: 1558111294
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 11D2296667
LAB Type Ambulance
Facility Name COMMUNITY CARE EMS LLC
Street 1939 SR-155 SOUTH, SUITE B
City MCDONOUGH
State GA
ZIP 30253
Phone 770 873-2012
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/4/2024
Certificate Expiration Date 1/3/2026
Facility Type Ambulance
Lab Director JOHNSON RUSSELL

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