11D0890208 CLIA NUMBER - GEORGIA UROLOGY PA SNELLVILLE

Laboratory Demographics

  • CLIA Code: 11D0890208
  • Facility Name: GEORGIA UROLOGY PA SNELLVILLE
  • Facility Address: 1700 TREE LANE ROAD, SUITE 420
    SNELLVILLE, GA
    ZIP 30078
  • Facility Phone: 770 979-9427
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. RONALD ANGLADE
  • NPI Number: 1417172602
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 11D0890208
LAB Type Physician Office
Facility Name GEORGIA UROLOGY PA SNELLVILLE
Street 1700 TREE LANE ROAD, SUITE 420
City SNELLVILLE
State GA
ZIP 30078
Phone 770 979-9427
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 10/23/2024
Certificate Expiration Date 10/22/2026
Facility Type Physician Office
Lab Director DR. RONALD ANGLADE

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