11D0923203 CLIA NUMBER - GREYSTONE OB/GYN PC

Laboratory Demographics

  • CLIA Code: 11D0923203
  • Facility Name: GREYSTONE OB/GYN PC
  • Facility Address: 3240 AVALON BOULEVARD
    CONYERS, GA
    ZIP 30013
  • Facility Phone: (770) 860-1575
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TIMOTHY COWTHORN
  • NPI Number: 1790839157
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 11D0923203
LAB Type Physician Office
Facility Name GREYSTONE OB/GYN PC
Street 3240 AVALON BOULEVARD
City CONYERS
State GA
ZIP 30013
Phone 7708601575
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/18/2024
Certificate Expiration Date 12/17/2026
Facility Type Physician Office
Lab Director TIMOTHY COWTHORN

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This page was last updated on: 5/18/2026