CLIA lab
CLIA 11D0969638: Mountainside Pediatrics LLC
Jasper, GA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 11D0969638 belongs to Mountainside Pediatrics LLC in Jasper, GA.
Certificate of Waiver, effective January 21, 2026, expires January 20, 2028.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- January 21, 2026
- Certificate expiration
- January 20, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- January 21, 2000
- Facility type
- Physician office
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 11D0969638
- Lab name
- Mountainside Pediatrics LLC
- Address
- 12 Sammy Mcghee Boulevard, Suite 102, Jasper, GA 30143
- Phone
- (706) 253-9898
- Fax
- (706) 253-9896
Annual test volume the lab reported
- Waived tests
- 300
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Jasper, GA
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- Airlife ThreeCertificate of Waiver, Ambulance11D2020272
- Amedisys Northwest, LLCCertificate of Waiver, Home health agency11D0695853
- Appalachian Hospice South, LLCCertificate of Waiver, Hospice11D2288607
- Aqua Dermatology of Georgia, PCCertificate of Waiver, Physician office11D2348693
- Big Canoe Public SafetyCertificate of Waiver, Other11D2198893
- City of Jasper Fire DepartmentCertificate of Waiver, Other11D2288324
- Digestive Healthcare of GeorgiaCertificate of Waiver, Physician office11D2120245
- Digestive Healthcare of Georgia Endoscopy CenterCertificate of Waiver, Ambulatory surgery center11D1091226
- Dragon Care/ Good Samaritan HealthCertificate of Waiver, Federally qualified health center11D2328077
Related
Questions
What is the CLIA number for Mountainside Pediatrics LLC in Jasper?
11D0969638, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Mountainside Pediatrics LLC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 11D0969638 expire?
The CMS file lists January 20, 2028 as the certificate expiration date; the certificate took effect January 21, 2026.