11D1015089 CLIA NUMBER - ATLANTA HEART SPECIALISTS LABORATORY

Laboratory Demographics

  • CLIA Code: 11D1015089
  • Facility Name: ATLANTA HEART SPECIALISTS LABORATORY
  • Facility Address: 1468 MONTREAL ROAD, EAST
    TUCKER, GA
    ZIP 30084
  • Facility Phone: 770 638-1400
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. DAVID SONG
  • NPI Number: 1891881827
  • Taxonomy: 207RI0011X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D1015089
LAB Type Physician Office
Facility Name ATLANTA HEART SPECIALISTS LABORATORY
Street 1468 MONTREAL ROAD, EAST
City TUCKER
State GA
ZIP 30084
Phone 770 638-1400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/5/2025
Certificate Expiration Date 10/4/2027
Facility Type Physician Office
Lab Director DR. DAVID SONG

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