11D0256380 CLIA NUMBER - ROBERT J PEZZIN MD

Laboratory Demographics

  • CLIA Code: 11D0256380
  • Facility Name: ROBERT J PEZZIN MD
  • Facility Address: 102 WILEY DRIVE
    CEDARTOWN, GA
    ZIP 30125
  • Facility Phone: 770 748-8940
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT J. PEZZIN
  • NPI Number: 1144241944
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0256380
LAB Type Physician Office
Facility Name ROBERT J PEZZIN MD
Street 102 WILEY DRIVE
City CEDARTOWN
State GA
ZIP 30125
Phone 770 748-8940
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/21/2025
Certificate Expiration Date 10/20/2027
Facility Type Physician Office
Lab Director ROBERT J. PEZZIN

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