11D2329550 CLIA NUMBER - CARTER TREATMENT CENTER, INCE, THE DBA IMAGINE WELLNESS CENTER

Laboratory Demographics

  • CLIA Code: 11D2329550
  • Facility Name: CARTER TREATMENT CENTER, INCE, THE DBA IMAGINE WELLNESS CENTER
  • Facility Address: 205 JEFF DAVIS PLACE
    FAYETTEVILLE, GA
    ZIP 30214
  • Facility Phone: 678 771-8468
  • Facility Type: Other - DRUG TREATMENT PROGRAM-OP
  • Facility Type: Waiver
  • Lab Director: KAMBIZ ALFATOON
  • NPI Number: 1518725308
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 11D2329550
LAB Type Other - DRUG TREATMENT PROGRAM-OP
Facility Name CARTER TREATMENT CENTER, INCE, THE DBA IMAGINE WELLNESS CENTER
Street 205 JEFF DAVIS PLACE
City FAYETTEVILLE
State GA
ZIP 30214
Phone 678 771-8468
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/30/2025
Certificate Expiration Date 8/29/2027
Facility Type Other - DRUG TREATMENT PROGRAM-OP
Lab Director KAMBIZ ALFATOON

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