11D0260285 CLIA NUMBER - DUNWOODY VILLAGE CLINIC PC

Laboratory Demographics

  • CLIA Code: 11D0260285
  • Facility Name: DUNWOODY VILLAGE CLINIC PC
  • Facility Address: 5471 CHAMBLEE-DUNWOODY ROAD
    DUNWOODY, GA
    ZIP 30338
  • Facility Phone: 770 481-0229
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JAMES J. KINAHAN
  • NPI Number: 1518335769
  • Taxonomy: 261QR0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D0260285
LAB Type Physician Office
Facility Name DUNWOODY VILLAGE CLINIC PC
Street 5471 CHAMBLEE-DUNWOODY ROAD
City DUNWOODY
State GA
ZIP 30338
Phone 770 481-0229
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 6/3/2024
Certificate Expiration Date 6/2/2026
Facility Type Physician Office
Lab Director JAMES J. KINAHAN

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This page was last updated on: 6/4/2025