11D2299119 CLIA NUMBER - ATLANTA HIV CONSULTANTS

Laboratory Demographics

  • CLIA Code: 11D2299119
  • Facility Name: ATLANTA HIV CONSULTANTS
  • Facility Address: 1000 IRIS DRIVE, SW, SUITE E-9
    CONYERS, GA
    ZIP 30094
  • Facility Phone: 833 448-4636
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: CASANDRA M. KIDD
  • NPI Number: 1932820719
  • Taxonomy: 247ZC0005X - Pathology

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CLIA Record

Field Name Field Value
CLIA Number 11D2299119
LAB Type Practitioner Other
Facility Name ATLANTA HIV CONSULTANTS
Street 1000 IRIS DRIVE, SW, SUITE E-9
City CONYERS
State GA
ZIP 30094
Phone 833 448-4636
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/14/2024
Certificate Expiration Date 2/13/2026
Facility Type Practitioner Other
Lab Director CASANDRA M. KIDD

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