11D0255606 CLIA NUMBER - ROSE BRIGLEVICH MD PC

Laboratory Demographics

  • CLIA Code: 11D0255606
  • Facility Name: ROSE BRIGLEVICH MD PC
  • Facility Address: 3969 SOUTH COBB DR STE 107
    SMYRNA, GA
    ZIP 30080
  • Facility Phone: 770 433-0434
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ROSE M. BRIGLEVICH
  • NPI Number: 1952395550
  • Taxonomy: 207R00000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D0255606
LAB Type Physician Office
Facility Name ROSE BRIGLEVICH MD PC
Street 3969 SOUTH COBB DR STE 107
City SMYRNA
State GA
ZIP 30080
Phone 770 433-0434
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 7/26/2025
Certificate Expiration Date 7/25/2027
Facility Type Physician Office
Lab Director ROSE M. BRIGLEVICH

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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