11D0997747 CLIA NUMBER - NORTHEAST GEORGIA PHYSICIANS GROUP CHESTNUT MOUNTAIN

Laboratory Demographics

  • CLIA Code: 11D0997747
  • Facility Name: NORTHEAST GEORGIA PHYSICIANS GROUP CHESTNUT MOUNTAIN
  • Facility Address: 4754 MARTIN ROAD
    FLOWERY BRANCH, GA
    ZIP 30542
  • Facility Phone: 770 848-9130
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: ERIC BOHN
  • NPI Number: 1225575855
  • Taxonomy: 213ES0103X - Podiatrist

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CLIA Record

Field Name Field Value
CLIA Number 11D0997747
LAB Type Physician Office
Facility Name NORTHEAST GEORGIA PHYSICIANS GROUP CHESTNUT MOUNTAIN
Street 4754 MARTIN ROAD
City FLOWERY BRANCH
State GA
ZIP 30542
Phone 770 848-9130
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 5/16/2024
Certificate Expiration Date 5/15/2026
Facility Type Physician Office
Lab Director ERIC BOHN

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