11D2313967 CLIA NUMBER - EDGECARE360 LLC

Laboratory Demographics

  • CLIA Code: 11D2313967
  • Facility Name: EDGECARE360 LLC
  • Facility Address: 2470 WINDY HILL ROAD, SUITE 300
    MARIETTA, GA
    ZIP 30067
  • Facility Phone: (770) 933-5328
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: BRYON EVAN
  • NPI Number: 1306590328
  • Taxonomy: 101YM0800X - Counselor

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CLIA Record

Field Name Field Value
CLIA Number 11D2313967
LAB Type Community Clinic
Facility Name EDGECARE360 LLC
Street 2470 WINDY HILL ROAD, SUITE 300
City MARIETTA
State GA
ZIP 30067
Phone 7709335328
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/12/2024
Certificate Expiration Date 11/11/2026
Facility Type Community Clinic
Lab Director BRYON EVAN

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This page was last updated on: 5/18/2026