11D1020143 CLIA NUMBER - GEORGIA UROLOGY - MIDTOWN

Laboratory Demographics

  • CLIA Code: 11D1020143
  • Facility Name: GEORGIA UROLOGY - MIDTOWN
  • Facility Address: 1110 WEST PEACHTREE STREET, NW, SUITE 1020
    ATLANTA, GA
    ZIP 30309
  • Facility Phone: 404 222-0292
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: WALTER Z. FALCONER
  • NPI Number: 1063637254
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 11D1020143
LAB Type Physician Office
Facility Name GEORGIA UROLOGY - MIDTOWN
Street 1110 WEST PEACHTREE STREET, NW, SUITE 1020
City ATLANTA
State GA
ZIP 30309
Phone 404 222-0292
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 12/12/2023
Certificate Expiration Date 12/11/2025
Facility Type Physician Office
Lab Director WALTER Z. FALCONER

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