11D0919086 CLIA NUMBER - WELLSTAR INTERNAL MEDICINE G A I M 2

Laboratory Demographics

  • CLIA Code: 11D0919086
  • Facility Name: WELLSTAR INTERNAL MEDICINE G A I M 2
  • Facility Address: 6043 PRESTLEY MILL ROAD, SUITE B
    DOUGLASVILLE, GA
    ZIP 30134
  • Facility Phone: 770 941-8100
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL PIANKSY
  • NPI Number: 1457766339
  • Taxonomy: 207RE0101X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0919086
LAB Type Physician Office
Facility Name WELLSTAR INTERNAL MEDICINE G A I M 2
Street 6043 PRESTLEY MILL ROAD, SUITE B
City DOUGLASVILLE
State GA
ZIP 30134
Phone 770 941-8100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/28/2024
Certificate Expiration Date 8/27/2026
Facility Type Physician Office
Lab Director MICHAEL PIANKSY

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