11D1015743 CLIA NUMBER - YONAH MOUNTAIN FAMILY PRACTICE PC DBA COUNTRY WAY FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 11D1015743
  • Facility Name: YONAH MOUNTAIN FAMILY PRACTICE PC DBA COUNTRY WAY FAMILY PRACTICE
  • Facility Address: 55 CANTRELL ROAD SUITE 100
    CLEVELAND, GA
    ZIP 30528
  • Facility Phone: 706 348-8763
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DENISE M. WORKMAN DO
  • NPI Number: 1194816280
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D1015743
LAB Type Physician Office
Facility Name YONAH MOUNTAIN FAMILY PRACTICE PC DBA COUNTRY WAY FAMILY PRACTICE
Street 55 CANTRELL ROAD SUITE 100
City CLEVELAND
State GA
ZIP 30528
Phone 706 348-8763
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 8/12/2025
Certificate Expiration Date 8/11/2027
Facility Type Physician Office
Lab Director DENISE M. WORKMAN DO

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