11D1004401 CLIA NUMBER - TIM CUMMINGS MD LLC

Laboratory Demographics

  • CLIA Code: 11D1004401
  • Facility Name: TIM CUMMINGS MD LLC
  • Facility Address: 1260 UPPER HEMBREE ROAD SUITE C
    ROSWELL, GA
    ZIP 30076
  • Facility Phone: 678 356-0484
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STEPHANIE D. BRADFORD
  • NPI Number: 1851572176
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 11D1004401
LAB Type Physician Office
Facility Name TIM CUMMINGS MD LLC
Street 1260 UPPER HEMBREE ROAD SUITE C
City ROSWELL
State GA
ZIP 30076
Phone 678 356-0484
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/26/2024
Certificate Expiration Date 9/25/2026
Facility Type Physician Office
Lab Director STEPHANIE D. BRADFORD

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