11D1065322 CLIA NUMBER - VINE MEDICAL ASSOCIATES

Laboratory Demographics

  • CLIA Code: 11D1065322
  • Facility Name: VINE MEDICAL ASSOCIATES
  • Facility Address: 11660 ALPHARETTA HWY STE 290
    ROSWELL, GA
    ZIP 30076
  • Facility Phone: 404 446-3600
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARGARET M. CHINNIS
  • NPI Number: 1598839953
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D1065322
LAB Type Physician Office
Facility Name VINE MEDICAL ASSOCIATES
Street 11660 ALPHARETTA HWY STE 290
City ROSWELL
State GA
ZIP 30076
Phone 404 446-3600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/27/2025
Certificate Expiration Date 2/26/2027
Facility Type Physician Office
Lab Director MARGARET M. CHINNIS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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