11D2012748 CLIA NUMBER - NEWNAN VASCULAR CENTER

Laboratory Demographics

  • CLIA Code: 11D2012748
  • Facility Name: NEWNAN VASCULAR CENTER
  • Facility Address: 2690 E HWY 34, SUITE A
    NEWNAN, GA
    ZIP 30265
  • Facility Phone: 678 423-4100
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANTHONY N. OBATA
  • NPI Number: 1144540519
  • Taxonomy: 261QM2500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2012748
LAB Type Physician Office
Facility Name NEWNAN VASCULAR CENTER
Street 2690 E HWY 34, SUITE A
City NEWNAN
State GA
ZIP 30265
Phone 678 423-4100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/9/2024
Certificate Expiration Date 9/8/2026
Facility Type Physician Office
Lab Director ANTHONY N. OBATA

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