CLIA lab
CLIA 11D2125695: Victory Village, PCH
Jasper, GA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 11D2125695 belongs to Victory Village, PCH in Jasper, GA.
Certificate of Waiver, effective February 13, 2025, expires February 12, 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
- February 13, 2025
- Certificate expiration
- February 12, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- February 13, 2017
- Facility type
- Assisted living facility
- 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
- 11D2125695
- Lab name
- Victory Village, PCH
- Address
- 3650 Salem Church Road, Jasper, GA 30143
- Phone
- (770) 735-2219
- Fax
- (770) 828-0698
Annual test volume the lab reported
- Waived tests
- 365
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Jasper, GA
- Advanced Urology Institute of Georgia, LLCCertificate of Waiver, Physician office11D2318645
- 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 Victory Village, PCH in Jasper?
11D2125695, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Victory Village, PCH hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 11D2125695 expire?
The CMS file lists February 12, 2027 as the certificate expiration date; the certificate took effect February 13, 2025.