11D0943320 CLIA NUMBER - GEORGIA UROLOGY PA, CANTON

Laboratory Demographics

  • CLIA Code: 11D0943320
  • Facility Name: GEORGIA UROLOGY PA, CANTON
  • Facility Address: 470 NORTHSIDE CHEROKEE BOULEVARD, SUITE 210
    CANTON, GA
    ZIP 30115
  • Facility Phone: 770 720-7246
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JOEL A. ROSENFIELD
  • NPI Number: 1609091891
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 11D0943320
LAB Type Physician Office
Facility Name GEORGIA UROLOGY PA, CANTON
Street 470 NORTHSIDE CHEROKEE BOULEVARD, SUITE 210
City CANTON
State GA
ZIP 30115
Phone 770 720-7246
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 3/25/2024
Certificate Expiration Date 3/24/2026
Facility Type Physician Office
Lab Director JOEL A. ROSENFIELD

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