11D0995868 CLIA NUMBER - GEORGIA UROLOGY PA

Laboratory Demographics

  • CLIA Code: 11D0995868
  • Facility Name: GEORGIA UROLOGY PA
  • Facility Address: 6000 HILLANDALE DRIVE SUITE 110
    LITHONIA, GA
    ZIP 30058
  • Facility Phone: 770 981-2090
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: WALTER Z. FALCONER
  • NPI Number: 1962627158
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 11D0995868
LAB Type Physician Office
Facility Name GEORGIA UROLOGY PA
Street 6000 HILLANDALE DRIVE SUITE 110
City LITHONIA
State GA
ZIP 30058
Phone 770 981-2090
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 2/4/2024
Certificate Expiration Date 2/3/2026
Facility Type Physician Office
Lab Director WALTER Z. FALCONER

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