11D2314907 CLIA NUMBER - UNFOLDING EVOLUTION HEALTHCARE LLC

Laboratory Demographics

  • CLIA Code: 11D2314907
  • Facility Name: UNFOLDING EVOLUTION HEALTHCARE LLC
  • Facility Address: 45 SOUTH AVENUE SE, SUITE 8
    MARIETTA, GA
    ZIP 30060
  • Facility Phone: 313 465-5438
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: MALAYSIA COTTON
  • NPI Number: 1104674159
  • Taxonomy: 253Z00000X - In Home Supportive Care

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CLIA Record

Field Name Field Value
CLIA Number 11D2314907
LAB Type Mobile Laboratory
Facility Name UNFOLDING EVOLUTION HEALTHCARE LLC
Street 45 SOUTH AVENUE SE, SUITE 8
City MARIETTA
State GA
ZIP 30060
Phone 313 465-5438
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/3/2024
Certificate Expiration Date 12/2/2026
Facility Type Mobile Laboratory
Lab Director MALAYSIA COTTON

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