CLIA lab

CLIA 11D2220495: Manor Lake Bridgemill

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

CLIA number 11D2220495 belongs to Manor Lake Bridgemill in Canton, GA.

Certificate of Waiver, effective April 13, 2025, expires April 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
April 13, 2025
Certificate expiration
April 12, 2027
Status in the CMS file
Active (termination code 00)
Original participation date
April 13, 2021
Facility type
Assisted living facility
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
11D2220495
Lab name
Manor Lake Bridgemill
Address
131 Holly Street, Canton, GA 30115
Phone
(678) 990-5055
Fax
(770) 213-7434

Annual test volume the lab reported

Waived tests
2,500

Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.

Other labs in Canton, GA

Related

Questions

What is the CLIA number for Manor Lake Bridgemill in Canton?

11D2220495, per the CMS Provider of Services file posted October 16, 2026.

What CLIA certificate does Manor Lake Bridgemill hold?

A Certificate of Waiver, according to the CMS file.

When does CLIA 11D2220495 expire?

The CMS file lists April 12, 2027 as the certificate expiration date; the certificate took effect April 13, 2025.

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