11D0983964 CLIA NUMBER - EAST COBB FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 11D0983964
  • Facility Name: EAST COBB FAMILY MEDICINE
  • Facility Address: 1121 JOHNSON FERRY ROAD, BUILDING 2, SUITE 100
    MARIETTA, GA
    ZIP 30068
  • Facility Phone: 770 509-0017
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BRIAN K. NADOLNE
  • NPI Number: 1003366147
  • Taxonomy: 1223P0221X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 11D0983964
LAB Type Physician Office
Facility Name EAST COBB FAMILY MEDICINE
Street 1121 JOHNSON FERRY ROAD, BUILDING 2, SUITE 100
City MARIETTA
State GA
ZIP 30068
Phone 770 509-0017
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/1/2025
Certificate Expiration Date 6/30/2027
Facility Type Physician Office
Lab Director BRIAN K. NADOLNE

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