CLIA lab

CLIA 11D2096889: Northside Jasper Radiology

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

CLIA number 11D2096889 belongs to Northside Jasper Radiology in Jasper, GA.

Certificate of Waiver, effective June 3, 2025, expires June 2, 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
June 3, 2025
Certificate expiration
June 2, 2027
Status in the CMS file
Active (termination code 00)
Original participation date
June 3, 2015
Facility type
Other
Ownership (control type)
Private
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
11D2096889
Lab name
Northside Jasper Radiology
Address
134 Mountainside Village Parkway Bldg 400, Jasper, GA 30143
Phone
(678) 388-5460
Fax
(678) 388-5461

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.

Other labs in Jasper, GA

Related

Questions

What is the CLIA number for Northside Jasper Radiology in Jasper?

11D2096889, per the CMS Provider of Services file posted October 16, 2026.

What CLIA certificate does Northside Jasper Radiology hold?

A Certificate of Waiver, according to the CMS file.

When does CLIA 11D2096889 expire?

The CMS file lists June 2, 2027 as the certificate expiration date; the certificate took effect June 3, 2025.

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