11D0717475 CLIA NUMBER - WELLSTAR OBGYN GRIFFIN

Laboratory Demographics

  • CLIA Code: 11D0717475
  • Facility Name: WELLSTAR OBGYN GRIFFIN
  • Facility Address: 503 SOUTH 8TH STREET
    GRIFFIN, GA
    ZIP 30224
  • Facility Phone: 770 227-5505
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JAMES B. DUNAWAY
  • NPI Number: 1558415919
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 11D0717475
LAB Type Physician Office
Facility Name WELLSTAR OBGYN GRIFFIN
Street 503 SOUTH 8TH STREET
City GRIFFIN
State GA
ZIP 30224
Phone 770 227-5505
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 6/22/2024
Certificate Expiration Date 6/21/2026
Facility Type Physician Office
Lab Director JAMES B. DUNAWAY

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