11D2314520 CLIA NUMBER - JUMPSTART HOSPICE AND PALLIATIVE CARE LLC

Laboratory Demographics

  • CLIA Code: 11D2314520
  • Facility Name: JUMPSTART HOSPICE AND PALLIATIVE CARE LLC
  • Facility Address: 3100 FIVE FORKS TRICKUM ROAD, SUITE 503 B
    LILBURN, GA
    ZIP 30047
  • Facility Phone: 678 333-3331
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: NICHOLE YAHTAL
  • NPI Number: 1417843236
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 11D2314520
LAB Type Hospice
Facility Name JUMPSTART HOSPICE AND PALLIATIVE CARE LLC
Street 3100 FIVE FORKS TRICKUM ROAD, SUITE 503 B
City LILBURN
State GA
ZIP 30047
Phone 678 333-3331
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/21/2024
Certificate Expiration Date 11/20/2026
Facility Type Hospice
Lab Director NICHOLE YAHTAL

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