11D0943323 CLIA NUMBER - GEORGIA UROLOGY PA CUMMING

Laboratory Demographics

  • CLIA Code: 11D0943323
  • Facility Name: GEORGIA UROLOGY PA CUMMING
  • Facility Address: 1800 NORTHSIDE FORSYTH DRIVE SUITE 370
    CUMMING, GA
    ZIP 30041
  • Facility Phone: 770 889-9737
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: CARL C. CAPELOUTO
  • NPI Number: 1780199356
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D0943323
LAB Type Physician Office
Facility Name GEORGIA UROLOGY PA CUMMING
Street 1800 NORTHSIDE FORSYTH DRIVE SUITE 370
City CUMMING
State GA
ZIP 30041
Phone 770 889-9737
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 CARL C. CAPELOUTO

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