11D0906124 CLIA NUMBER - WELLSTAR POWDER SPRINGS MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 11D0906124
  • Facility Name: WELLSTAR POWDER SPRINGS MEDICAL CENTER
  • Facility Address: 4250 BROWNSVILLE RD
    POWDER SPRINGS, GA
    ZIP 30127
  • Facility Phone: 678 567-8000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL CHRISTA
  • NPI Number: 1093011603
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0906124
LAB Type Physician Office
Facility Name WELLSTAR POWDER SPRINGS MEDICAL CENTER
Street 4250 BROWNSVILLE RD
City POWDER SPRINGS
State GA
ZIP 30127
Phone 678 567-8000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/19/2025
Certificate Expiration Date 6/18/2027
Facility Type Physician Office
Lab Director MICHAEL CHRISTA

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