11D0684556 CLIA NUMBER - ROSWELL PEDIATRIC CENTER PC

Laboratory Demographics

  • CLIA Code: 11D0684556
  • Facility Name: ROSWELL PEDIATRIC CENTER PC
  • Facility Address: 11525 HAYNES BRIDGE ROAD, SUITE 200
    ALPHARETTA, GA
    ZIP 30009
  • Facility Phone: 770 751-0800
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: DR. BRIAN BURNHAM
  • NPI Number: 1487772596
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D0684556
LAB Type Physician Office
Facility Name ROSWELL PEDIATRIC CENTER PC
Street 11525 HAYNES BRIDGE ROAD, SUITE 200
City ALPHARETTA
State GA
ZIP 30009
Phone 770 751-0800
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 11/6/2023
Certificate Expiration Date 11/5/2025
Facility Type Physician Office
Lab Director DR. BRIAN BURNHAM

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