11D2305163 CLIA NUMBER - CLASSIC EMS INC

Laboratory Demographics

  • CLIA Code: 11D2305163
  • Facility Name: CLASSIC EMS INC
  • Facility Address: 442 DUCK ROAD
    BRASELTON, GA
    ZIP 30517
  • Facility Phone: 404 819-6488
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: BIBI A. ALI
  • NPI Number: 1336995026
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 11D2305163
LAB Type Ambulance
Facility Name CLASSIC EMS INC
Street 442 DUCK ROAD
City BRASELTON
State GA
ZIP 30517
Phone 404 819-6488
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 BIBI A. ALI

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