11D1103011 CLIA NUMBER - CARDIOVASCULAR ASSOCIATES OF SANDY SPRINGS LLC

Laboratory Demographics

  • CLIA Code: 11D1103011
  • Facility Name: CARDIOVASCULAR ASSOCIATES OF SANDY SPRINGS LLC
  • Facility Address: 960 JOHNSON FERRY ROAD SUITE 530
    ATLANTA, GA
    ZIP 30342
  • Facility Phone: 404 446-1900
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MERVYN B. FORMAN
  • NPI Number: 1912165382
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D1103011
LAB Type Physician Office
Facility Name CARDIOVASCULAR ASSOCIATES OF SANDY SPRINGS LLC
Street 960 JOHNSON FERRY ROAD SUITE 530
City ATLANTA
State GA
ZIP 30342
Phone 404 446-1900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/31/2025
Certificate Expiration Date 7/30/2027
Facility Type Physician Office
Lab Director MERVYN B. FORMAN

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