11D2016456 CLIA NUMBER - DR SIRUVELLA MD, PC

Laboratory Demographics

  • CLIA Code: 11D2016456
  • Facility Name: DR SIRUVELLA MD, PC
  • Facility Address: 512 GREAT OAKS DRIVE
    MONROE, GA
    ZIP 30655
  • Facility Phone: 770 266-0567
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SRIDEVI SIRUVELLA
  • NPI Number: 1447567631
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2016456
LAB Type Physician Office
Facility Name DR SIRUVELLA MD, PC
Street 512 GREAT OAKS DRIVE
City MONROE
State GA
ZIP 30655
Phone 770 266-0567
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/18/2024
Certificate Expiration Date 11/17/2026
Facility Type Physician Office
Lab Director SRIDEVI SIRUVELLA

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