11D0256155 CLIA NUMBER - CHEROKEE PEDIATRICS

Laboratory Demographics

  • CLIA Code: 11D0256155
  • Facility Name: CHEROKEE PEDIATRICS
  • Facility Address: 134 RIVERSTONE TERRACE, SUITE 103
    CANTON, GA
    ZIP 30114
  • Facility Phone: 770 479-1985
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JONATHAN A. CHEEK MD
  • NPI Number: 1922261106
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D0256155
LAB Type Physician Office
Facility Name CHEROKEE PEDIATRICS
Street 134 RIVERSTONE TERRACE, SUITE 103
City CANTON
State GA
ZIP 30114
Phone 770 479-1985
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 5/3/2024
Certificate Expiration Date 5/2/2026
Facility Type Physician Office
Lab Director JONATHAN A. CHEEK MD

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