11D2028521 CLIA NUMBER - PEDIATRIC ASSOCIATES, PC

Laboratory Demographics

  • CLIA Code: 11D2028521
  • Facility Name: PEDIATRIC ASSOCIATES, PC
  • Facility Address: 2863 JOHNSON FERRY ROAD, SUITE 100
    MARIETTA, GA
    ZIP 30062
  • Facility Phone: 770 993-2922
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: ROBERT M. LICATA
  • NPI Number: 1790994317
  • Taxonomy: 208000000X - Pediatrics

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2028521
LAB Type Physician Office
Facility Name PEDIATRIC ASSOCIATES, PC
Street 2863 JOHNSON FERRY ROAD, SUITE 100
City MARIETTA
State GA
ZIP 30062
Phone 770 993-2922
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 12/20/2023
Certificate Expiration Date 12/19/2025
Facility Type Physician Office
Lab Director ROBERT M. LICATA

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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