11D2321623 CLIA NUMBER - ASTOUNDING HOSPICE LLC

Laboratory Demographics

  • CLIA Code: 11D2321623
  • Facility Name: ASTOUNDING HOSPICE LLC
  • Facility Address: 1572 GA - 85 N, SUITE 305
    FAYETTEVILLE, GA
    ZIP 30214
  • Facility Phone: 770 708-4901
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: REGGIE L. COOK
  • NPI Number: 1538992151
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 11D2321623
LAB Type Hospice
Facility Name ASTOUNDING HOSPICE LLC
Street 1572 GA - 85 N, SUITE 305
City FAYETTEVILLE
State GA
ZIP 30214
Phone 770 708-4901
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/7/2025
Certificate Expiration Date 4/6/2027
Facility Type Hospice
Lab Director REGGIE L. COOK

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