11D0255010 CLIA NUMBER - IMANI D VANNOY MD PC

Laboratory Demographics

  • CLIA Code: 11D0255010
  • Facility Name: IMANI D VANNOY MD PC
  • Facility Address: 741 CHANCE ROAD
    MARIETTA, GA
    ZIP 30066
  • Facility Phone: 770 977-5355
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: IMANI VANNOY
  • NPI Number: 1376596783
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0255010
LAB Type Physician Office
Facility Name IMANI D VANNOY MD PC
Street 741 CHANCE ROAD
City MARIETTA
State GA
ZIP 30066
Phone 770 977-5355
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/4/2024
Certificate Expiration Date 3/3/2026
Facility Type Physician Office
Lab Director IMANI VANNOY

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This page was last updated on: 9/29/2025