11D0902138 CLIA NUMBER - GEORGIA UROLOGY PA CAMP CREEK

Laboratory Demographics

  • CLIA Code: 11D0902138
  • Facility Name: GEORGIA UROLOGY PA CAMP CREEK
  • Facility Address: 3890 REDWIND ROAD SUITE 112
    ATLANTA, GA
    ZIP 30331
  • Facility Phone: 404 766-7151
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DARRELL CARMEN
  • NPI Number: 1326263518
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 11D0902138
LAB Type Physician Office
Facility Name GEORGIA UROLOGY PA CAMP CREEK
Street 3890 REDWIND ROAD SUITE 112
City ATLANTA
State GA
ZIP 30331
Phone 404 766-7151
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 6/14/2025
Certificate Expiration Date 6/13/2027
Facility Type Physician Office
Lab Director DARRELL CARMEN

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