11D0969885 CLIA NUMBER - COVINGTON ONE MEDICAL, LLC

Laboratory Demographics

  • CLIA Code: 11D0969885
  • Facility Name: COVINGTON ONE MEDICAL, LLC
  • Facility Address: 1065 ACCESS ROAD, SUITE D
    COVINGTON, GA
    ZIP 30014
  • Facility Phone: 770 385-0045
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STAR YE
  • NPI Number: 1174732747
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0969885
LAB Type Physician Office
Facility Name COVINGTON ONE MEDICAL, LLC
Street 1065 ACCESS ROAD, SUITE D
City COVINGTON
State GA
ZIP 30014
Phone 770 385-0045
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/7/2025
Certificate Expiration Date 1/6/2027
Facility Type Physician Office
Lab Director STAR YE

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