11D1076789 CLIA NUMBER - AGC PEDIATRIC LLC

Laboratory Demographics

  • CLIA Code: 11D1076789
  • Facility Name: AGC PEDIATRIC LLC
  • Facility Address: 5 MEDICAL DRIVE, NE
    CARTERSVILLE, GA
    ZIP 30121
  • Facility Phone: 706 625-5900
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOSEPH L. JOYANE
  • NPI Number: 1356475214
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 11D1076789
LAB Type Physician Office
Facility Name AGC PEDIATRIC LLC
Street 5 MEDICAL DRIVE, NE
City CARTERSVILLE
State GA
ZIP 30121
Phone 706 625-5900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/13/2024
Certificate Expiration Date 5/12/2026
Facility Type Physician Office
Lab Director JOSEPH L. JOYANE

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