CLIA lab
CLIA 11D1072994: Healthstat Incorporate on Site Clinic
Pine Mountain, GA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 11D1072994 belongs to Healthstat Incorporate on Site Clinic in Pine Mountain, GA.
Certificate of Waiver, effective August 29, 2025, expires August 28, 2027.
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
- August 29, 2025
- Certificate expiration
- August 28, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- August 29, 2007
- Facility type
- Other
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
- Directly affiliated labs
- 1
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 11D1072994
- Lab name
- Healthstat Incorporate on Site Clinic
- Additional name
- Milliken Pine Mountain
- Address
- 7495 Hamilton Road, Pine Mountain, GA 31822
- Phone
- (704) 529-6161
- Fax
- (704) 529-6572
Annual test volume the lab reported
- Waived tests
- 250
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Affiliated CLIA numbers
Other labs in Pine Mountain, GA
Related
Questions
What is the CLIA number for Healthstat Incorporate on Site Clinic in Pine Mountain?
11D1072994, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Healthstat Incorporate on Site Clinic hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 11D1072994 expire?
The CMS file lists August 28, 2027 as the certificate expiration date; the certificate took effect August 29, 2025.