CLIA lab

CLIA 11D1073391: Healthstat Incorporate on Site Clinic

Lagrange, GA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.

CLIA number 11D1073391 belongs to Healthstat Incorporate on Site Clinic in Lagrange, GA.

Certificate of Waiver, effective September 10, 2025, expires September 9, 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
September 10, 2025
Certificate expiration
September 9, 2027
Status in the CMS file
Active (termination code 00)
Original participation date
September 10, 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
11D1073391
Lab name
Healthstat Incorporate on Site Clinic
Additional name
Milliken Duncan Stewart
Address
714 Stewart Road, Lagrange, GA 30240
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 Lagrange, GA

Related

Questions

What is the CLIA number for Healthstat Incorporate on Site Clinic in Lagrange?

11D1073391, 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 11D1073391 expire?

The CMS file lists September 9, 2027 as the certificate expiration date; the certificate took effect September 10, 2025.

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