11D0255049 CLIA NUMBER - WELLSTAR URGENT CARE SHALLOWFORD

Laboratory Demographics

  • CLIA Code: 11D0255049
  • Facility Name: WELLSTAR URGENT CARE SHALLOWFORD
  • Facility Address: 3600 SANDY PLAINS ROAD
    MARIETTA, GA
    ZIP 30066
  • Facility Phone: (770) 977-4547
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: JETHWA KRUNAL
  • NPI Number: 1013202712
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D0255049
LAB Type Physician Office
Facility Name WELLSTAR URGENT CARE SHALLOWFORD
Street 3600 SANDY PLAINS ROAD
City MARIETTA
State GA
ZIP 30066
Phone 7709774547
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 6/17/2025
Certificate Expiration Date 6/16/2027
Facility Type Physician Office
Lab Director JETHWA KRUNAL

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This page was last updated on: 5/18/2026