11D0704375 CLIA NUMBER - PIEDMONT PHYSICIANS PEDIATRICS AT JEFFERSON PKWY

Laboratory Demographics

  • CLIA Code: 11D0704375
  • Facility Name: PIEDMONT PHYSICIANS PEDIATRICS AT JEFFERSON PKWY
  • Facility Address: 189 JEFFERSON PARKWAY
    NEWNAN, GA
    ZIP 30263
  • Facility Phone: 770 254-6157
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JASMINA RICE MD
  • NPI Number: 1447315742
  • Taxonomy: 208000000X - Pediatrics

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D0704375
LAB Type Physician Office
Facility Name PIEDMONT PHYSICIANS PEDIATRICS AT JEFFERSON PKWY
Street 189 JEFFERSON PARKWAY
City NEWNAN
State GA
ZIP 30263
Phone 770 254-6157
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/21/2025
Certificate Expiration Date 3/20/2027
Facility Type Physician Office
Lab Director JASMINA RICE MD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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