11D0255194 CLIA NUMBER - EAST COBB PEDIATRICS & ADOLESCENT MEDICINE

Laboratory Demographics

CLIA Number: 11D0255194

Facility Name: EAST COBB PEDIATRICS & ADOLESCENT MEDICINE

Facility Address:
1121 JOHNSON FERRY RD STE 220
MARIETTA, GA
ZIP 30068
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Facility Phone Number: 770 977-0094

Facility Type: Physician Office

Certificate Type: Accreditation

NPI Number: 1841337896

Taxonomy: 2080A0000X - Pediatrics
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.

CLIA Record

Field Name	Field Value
CLIA Number	11D0255194
LAB Type	Physician Office
Facility Name	EAST COBB PEDIATRICS & ADOLESCENT MEDICINE
Street	1121 JOHNSON FERRY RD STE 220
City	MARIETTA
State	GA
ZIP	30068
Phone	770 977-0094
CertificateType	1
CertificateEffectiveDate	12/23/2023
CertificateExpirationDate	12/22/2025
FacilityType	Accreditation

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This page was last updated on: 4/23/2024