11D2043258 CLIA NUMBER - WALK-IN MD

Laboratory Demographics

  • CLIA Code: 11D2043258
  • Facility Name: WALK-IN MD
  • Facility Address: 179-B PINE GROVE ROAD
    CARTERSVILLE, GA
    ZIP 30120
  • Facility Phone: 770 387-4544
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JERRY MARK WIGLEY
  • NPI Number: 1558628701
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2043258
LAB Type Physician Office
Facility Name WALK-IN MD
Street 179-B PINE GROVE ROAD
City CARTERSVILLE
State GA
ZIP 30120
Phone 770 387-4544
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/8/2024
Certificate Expiration Date 9/7/2026
Facility Type Physician Office
Lab Director DR. JERRY MARK WIGLEY

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