11D1071737 CLIA NUMBER - EAST ATLANTA CARDIOLOGY

Laboratory Demographics

  • CLIA Code: 11D1071737
  • Facility Name: EAST ATLANTA CARDIOLOGY
  • Facility Address: 1372 WELLBROOKE CIRCLE
    CONYERS, GA
    ZIP 30012
  • Facility Phone: 770 377-8881
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SRINIVASAN MUTHAYYAH MD
  • NPI Number: 1558899682
  • Taxonomy: 261QA1903X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D1071737
LAB Type Physician Office
Facility Name EAST ATLANTA CARDIOLOGY
Street 1372 WELLBROOKE CIRCLE
City CONYERS
State GA
ZIP 30012
Phone 770 377-8881
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/2/2025
Certificate Expiration Date 9/1/2027
Facility Type Physician Office
Lab Director SRINIVASAN MUTHAYYAH MD

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