11D0723457 CLIA NUMBER - DOURRON NORTHSIDE OBGYN

Laboratory Demographics

  • CLIA Code: 11D0723457
  • Facility Name: DOURRON NORTHSIDE OBGYN
  • Facility Address: 755 COMMERCE DRIVE, SUITE 301
    DECATUR, GA
    ZIP 30030
  • Facility Phone: 404 294-0472
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JULIE DOURRON
  • NPI Number: 1255525853
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 11D0723457
LAB Type Physician Office
Facility Name DOURRON NORTHSIDE OBGYN
Street 755 COMMERCE DRIVE, SUITE 301
City DECATUR
State GA
ZIP 30030
Phone 404 294-0472
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director JULIE DOURRON

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