11D0256258 CLIA NUMBER - CARROLLTON OBGYN

Laboratory Demographics

  • CLIA Code: 11D0256258
  • Facility Name: CARROLLTON OBGYN
  • Facility Address: 706 DIXIE STREET SUITE 200B
    CARROLLTON, GA
    ZIP 30117
  • Facility Phone: 770 214-2229
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DANIEL R. NELSON
  • NPI Number: 1790724672
  • Taxonomy: 207P00000X - Emergency Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0256258
LAB Type Physician Office
Facility Name CARROLLTON OBGYN
Street 706 DIXIE STREET SUITE 200B
City CARROLLTON
State GA
ZIP 30117
Phone 770 214-2229
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 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director DANIEL R. NELSON

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