11D0258685 CLIA NUMBER - MIDTOWN UROLOGY

Laboratory Demographics

  • CLIA Code: 11D0258685
  • Facility Name: MIDTOWN UROLOGY
  • Facility Address: 1924 PIEDMONT ROAD, NE
    ATLANTA, GA
    ZIP 30324
  • Facility Phone: 404 881-0966
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JENELLE E. FOOTE
  • NPI Number: 1902852841
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D0258685
LAB Type Physician Office
Facility Name MIDTOWN UROLOGY
Street 1924 PIEDMONT ROAD, NE
City ATLANTA
State GA
ZIP 30324
Phone 404 881-0966
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 2/14/2024
Certificate Expiration Date 2/13/2026
Facility Type Physician Office
Lab Director JENELLE E. FOOTE

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