11D2302223 CLIA NUMBER - 9 LINE HEALTH, LLC

Laboratory Demographics

  • CLIA Code: 11D2302223
  • Facility Name: 9 LINE HEALTH, LLC
  • Facility Address: 101 C W NORTHSIDE DRIVE
    VALDOSTA, GA
    ZIP 31602
  • Facility Phone: 229 808-2230
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: WENDY VANDEMARK
  • NPI Number: 1144090226
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 11D2302223
LAB Type Comp. Outpatient Rehab Facility
Facility Name 9 LINE HEALTH, LLC
Street 101 C W NORTHSIDE DRIVE
City VALDOSTA
State GA
ZIP 31602
Phone 229 808-2230
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/8/2024
Certificate Expiration Date 4/7/2026
Facility Type Comp. Outpatient Rehab Facility
Lab Director WENDY VANDEMARK

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