11D0879792 CLIA NUMBER - ATHENS HEART CENTER

Laboratory Demographics

  • CLIA Code: 11D0879792
  • Facility Name: ATHENS HEART CENTER
  • Facility Address: 2005 PRINCE AVE
    ATHENS, GA
    ZIP 30606
  • Facility Phone: 404 867-7727
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SUBODH K. AGRAWAL
  • NPI Number: 1447338744
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0879792
LAB Type Physician Office
Facility Name ATHENS HEART CENTER
Street 2005 PRINCE AVE
City ATHENS
State GA
ZIP 30606
Phone 404 867-7727
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/2/2023
Certificate Expiration Date 12/1/2025
Facility Type Physician Office
Lab Director SUBODH K. AGRAWAL

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