11D1020866 CLIA NUMBER - CONCENTRA - MARIETTA

Laboratory Demographics

  • CLIA Code: 11D1020866
  • Facility Name: CONCENTRA - MARIETTA
  • Facility Address: 220 N COBB PARKWAY SUITE 400
    MARIETTA, GA
    ZIP 30062
  • Facility Phone: 770 424-7125
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PAUL HORNER
  • NPI Number: 1124210711
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D1020866
LAB Type Physician Office
Facility Name CONCENTRA - MARIETTA
Street 220 N COBB PARKWAY SUITE 400
City MARIETTA
State GA
ZIP 30062
Phone 770 424-7125
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/4/2025
Certificate Expiration Date 5/3/2027
Facility Type Physician Office
Lab Director PAUL HORNER

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