11D1058722 CLIA NUMBER - ATLANTA PSYCHOTHERAPY

Laboratory Demographics

  • CLIA Code: 11D1058722
  • Facility Name: ATLANTA PSYCHOTHERAPY
  • Facility Address: 831 FAIRWAYS COURT, SUITE A
    STOCKBRIDGE, GA
    ZIP 30281
  • Facility Phone: 770 389-1925
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DOROTHY WATTS
  • NPI Number: 1548228281
  • Taxonomy: 101Y00000X - Counselor

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CLIA Record

Field Name Field Value
CLIA Number 11D1058722
LAB Type Physician Office
Facility Name ATLANTA PSYCHOTHERAPY
Street 831 FAIRWAYS COURT, SUITE A
City STOCKBRIDGE
State GA
ZIP 30281
Phone 770 389-1925
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/14/2024
Certificate Expiration Date 9/13/2026
Facility Type Physician Office
Lab Director DOROTHY WATTS

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