11D0936937 CLIA NUMBER - NICHOLAS PIETRZAK, MD, LLC

Laboratory Demographics

  • CLIA Code: 11D0936937
  • Facility Name: NICHOLAS PIETRZAK, MD, LLC
  • Facility Address: 3951 RIDGE AVE SUITE B
    MACON, GA
    ZIP 31210
  • Facility Phone: 478 757-1934
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: NICHOLAS PIETRZAK
  • NPI Number: 1790792034
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0936937
LAB Type Physician Office
Facility Name NICHOLAS PIETRZAK, MD, LLC
Street 3951 RIDGE AVE SUITE B
City MACON
State GA
ZIP 31210
Phone 478 757-1934
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 11/12/2024
Certificate Expiration Date 11/11/2026
Facility Type Physician Office
Lab Director NICHOLAS PIETRZAK

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