11D2305152 CLIA NUMBER - ACTIVE CARE EMS INC

Laboratory Demographics

  • CLIA Code: 11D2305152
  • Facility Name: ACTIVE CARE EMS INC
  • Facility Address: 442 DUCK ROAD
    BRASELTON, GA
    ZIP 30517
  • Facility Phone: 470 370-5996
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: MATRICIA CHALMERS
  • NPI Number: 1033256862
  • Taxonomy: 225100000X - Physical Therapist

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CLIA Record

Field Name Field Value
CLIA Number 11D2305152
LAB Type Ambulance
Facility Name ACTIVE CARE EMS INC
Street 442 DUCK ROAD
City BRASELTON
State GA
ZIP 30517
Phone 470 370-5996
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/28/2024
Certificate Expiration Date 5/27/2026
Facility Type Ambulance
Lab Director MATRICIA CHALMERS

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