11D0259804 CLIA NUMBER - SANDY SPRINGS INTERNAL MEDICINE PC

Laboratory Demographics

  • CLIA Code: 11D0259804
  • Facility Name: SANDY SPRINGS INTERNAL MEDICINE PC
  • Facility Address: 755 MT VERNON HWY SUITE 500
    ATLANTA, GA
    ZIP 30328
  • Facility Phone: 404 256-9544
  • Facility Type: Practitioner Other
  • Facility Type: Microscopy
  • Lab Director: KELLY J. AHN MD
  • NPI Number: 1952922098
  • Taxonomy: 207L00000X - Anesthesiology

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CLIA Record

Field Name Field Value
CLIA Number 11D0259804
LAB Type Practitioner Other
Facility Name SANDY SPRINGS INTERNAL MEDICINE PC
Street 755 MT VERNON HWY SUITE 500
City ATLANTA
State GA
ZIP 30328
Phone 404 256-9544
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 12/25/2024
Certificate Expiration Date 12/24/2026
Facility Type Practitioner Other
Lab Director KELLY J. AHN MD

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