11D0679038 CLIA NUMBER - WEST ATLANTA PEDIATRICS

Laboratory Demographics

  • CLIA Code: 11D0679038
  • Facility Name: WEST ATLANTA PEDIATRICS
  • Facility Address: 915 THORNTON ROAD
    LITHIA SPRINGS, GA
    ZIP 30122
  • Facility Phone: 770 739-9292
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EARL Y. YOUNG
  • NPI Number: 1437362225
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D0679038
LAB Type Physician Office
Facility Name WEST ATLANTA PEDIATRICS
Street 915 THORNTON ROAD
City LITHIA SPRINGS
State GA
ZIP 30122
Phone 770 739-9292
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/28/2025
Certificate Expiration Date 2/27/2027
Facility Type Physician Office
Lab Director EARL Y. YOUNG

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