11D0943322 CLIA NUMBER - GEORGIA UROLOGY PA CARTERSVILLE

Laboratory Demographics

  • CLIA Code: 11D0943322
  • Facility Name: GEORGIA UROLOGY PA CARTERSVILLE
  • Facility Address: 9 MEDICAL DRIVE NE, SUITE A
    CARTERSVILLE, GA
    ZIP 30121
  • Facility Phone: 770 607-1893
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JEFFREY G. PROCTOR
  • NPI Number: 1548541030
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 11D0943322
LAB Type Physician Office
Facility Name GEORGIA UROLOGY PA CARTERSVILLE
Street 9 MEDICAL DRIVE NE, SUITE A
City CARTERSVILLE
State GA
ZIP 30121
Phone 770 607-1893
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 JEFFREY G. PROCTOR

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