11D2309462 CLIA NUMBER - BLOOD DIAMOND MOBILE LABORATORY LLC

Laboratory Demographics

  • CLIA Code: 11D2309462
  • Facility Name: BLOOD DIAMOND MOBILE LABORATORY LLC
  • Facility Address: 889 COMMERCE DRIVE SW, SUITE C
    CONYERS, GA
    ZIP 30094
  • Facility Phone: 770 762-6019
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: ROXANN A. DOOLING
  • NPI Number: 1184472441
  • Taxonomy: 246RP1900X - Technician, Pathology

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CLIA Record

Field Name Field Value
CLIA Number 11D2309462
LAB Type Independent
Facility Name BLOOD DIAMOND MOBILE LABORATORY LLC
Street 889 COMMERCE DRIVE SW, SUITE C
City CONYERS
State GA
ZIP 30094
Phone 770 762-6019
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/15/2024
Certificate Expiration Date 8/14/2026
Facility Type Independent
Lab Director ROXANN A. DOOLING

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