11D2065242 CLIA NUMBER - TALBOTT AT DUNWOODY

Laboratory Demographics

  • CLIA Code: 11D2065242
  • Facility Name: TALBOTT AT DUNWOODY
  • Facility Address: 4480 NORTH SHALLOWFORD ROAD, SUITE 224
    DUNWOODY, GA
    ZIP 30338
  • Facility Phone: 678 251-3100
  • Facility Type: Other - BEHAV HLTH-DRUG&ALC
  • Facility Type: Waiver
  • Lab Director: RENEE PRENCIPE
  • NPI Number: 1477835296
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2065242
LAB Type Other - BEHAV HLTH-DRUG&ALC
Facility Name TALBOTT AT DUNWOODY
Street 4480 NORTH SHALLOWFORD ROAD, SUITE 224
City DUNWOODY
State GA
ZIP 30338
Phone 678 251-3100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/6/2025
Certificate Expiration Date 9/5/2027
Facility Type Other - BEHAV HLTH-DRUG&ALC
Lab Director RENEE PRENCIPE

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