11D2000572 CLIA NUMBER - GEORGIA HEART INSTITUE LLC- CUMMING

Laboratory Demographics

  • CLIA Code: 11D2000572
  • Facility Name: GEORGIA HEART INSTITUE LLC- CUMMING
  • Facility Address: 900 SANDERS ROAD SUITE A
    CUMMING, GA
    ZIP 30041
  • Facility Phone: 770 297-3547
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MITCHELL G. DAVIS
  • NPI Number: 1689728636
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 11D2000572
LAB Type Physician Office
Facility Name GEORGIA HEART INSTITUE LLC- CUMMING
Street 900 SANDERS ROAD SUITE A
City CUMMING
State GA
ZIP 30041
Phone 770 297-3547
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/3/2023
Certificate Expiration Date 12/2/2025
Facility Type Physician Office
Lab Director DR. MITCHELL G. DAVIS

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