11D0958978 CLIA NUMBER - MED GLOBE PC

Laboratory Demographics

  • CLIA Code: 11D0958978
  • Facility Name: MED GLOBE PC
  • Facility Address: 1686 ROSWELL ROAD
    MARIETTA, GA
    ZIP 30062
  • Facility Phone: 770 933-9333
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MANDANA R. AMIRI MD
  • NPI Number: 1689736407
  • Taxonomy: 207R00000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D0958978
LAB Type Physician Office
Facility Name MED GLOBE PC
Street 1686 ROSWELL ROAD
City MARIETTA
State GA
ZIP 30062
Phone 770 933-9333
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 3/31/2025
Certificate Expiration Date 3/30/2027
Facility Type Physician Office
Lab Director MANDANA R. AMIRI MD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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