11D1010236 CLIA NUMBER - NORTH GEORGIA UROLOGY CENTER

Laboratory Demographics

CLIA Number: 11D1010236

Facility Name: NORTH GEORGIA UROLOGY CENTER

Facility Address:
1434 BROADRICK DRIVE
DALTON, GA
ZIP 30720
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Facility Phone Number: 706 278-5961

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1033580295

Taxonomy: 208800000X - Urology
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

CLIA Record

Field Name	Field Value
CLIA Number	11D1010236
LAB Type	Physician Office
Facility Name	NORTH GEORGIA UROLOGY CENTER
Street	1434 BROADRICK DRIVE
City	DALTON
State	GA
ZIP	30720
Phone	706 278-5961
CertificateType	2
CertificateEffectiveDate	11/19/2023
CertificateExpirationDate	11/18/2025
FacilityType	Compliance

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This page was last updated on: 4/23/2024