11D0989779 CLIA NUMBER - MY OB/GYN KATZ GLADSTONE RABIN MD'S PC

Laboratory Demographics

  • CLIA Code: 11D0989779
  • Facility Name: MY OB/GYN KATZ GLADSTONE RABIN MD'S PC
  • Facility Address: 81 UPPER RIVERDALE ROAD, SUITE 210
    RIVERDALE, GA
    ZIP 30274
  • Facility Phone: 770 996-1200
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: LETITIA ROYSTER MD
  • NPI Number: 1669534210
  • Taxonomy: 174400000X - Specialist

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D0989779
LAB Type Physician Office
Facility Name MY OB/GYN KATZ GLADSTONE RABIN MD'S PC
Street 81 UPPER RIVERDALE ROAD, SUITE 210
City RIVERDALE
State GA
ZIP 30274
Phone 770 996-1200
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 8/6/2025
Certificate Expiration Date 8/5/2027
Facility Type Physician Office
Lab Director LETITIA ROYSTER 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