11D1048549 CLIA NUMBER - EDWARDS MEDICAL PRACTICE LLC

Laboratory Demographics

  • CLIA Code: 11D1048549
  • Facility Name: EDWARDS MEDICAL PRACTICE LLC
  • Facility Address: 86 SEASONS LANE
    HIAWASSEE, GA
    ZIP 30546
  • Facility Phone: 706 896-6701
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: TRACY L. EDWARD
  • NPI Number: 1881751428
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D1048549
LAB Type Physician Office
Facility Name EDWARDS MEDICAL PRACTICE LLC
Street 86 SEASONS LANE
City HIAWASSEE
State GA
ZIP 30546
Phone 706 896-6701
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 12/5/2023
Certificate Expiration Date 12/4/2025
Facility Type Physician Office
Lab Director TRACY L. EDWARD

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