11D1046397 CLIA NUMBER - CHILDRENS WELLNESS CENTER

Laboratory Demographics

  • CLIA Code: 11D1046397
  • Facility Name: CHILDRENS WELLNESS CENTER
  • Facility Address: 5883 GLENRIDGE DRIVE NE SUITE 100
    ATLANTA, GA
    ZIP 30328
  • Facility Phone: 404 303-1314
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JULIE SEGAL
  • NPI Number: 1306995832
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D1046397
LAB Type Physician Office
Facility Name CHILDRENS WELLNESS CENTER
Street 5883 GLENRIDGE DRIVE NE SUITE 100
City ATLANTA
State GA
ZIP 30328
Phone 404 303-1314
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/17/2024
Certificate Expiration Date 9/16/2026
Facility Type Physician Office
Lab Director JULIE SEGAL

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