11D2065716 CLIA NUMBER - WEST VININGS PEDIATRIC GROUP, PC

Laboratory Demographics

  • CLIA Code: 11D2065716
  • Facility Name: WEST VININGS PEDIATRIC GROUP, PC
  • Facility Address: 3644 HIGHLANDS PARKWAY
    SMYRNA, GA
    ZIP 30082
  • Facility Phone: 404 446-3960
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CRYSTAL L. WHITE
  • NPI Number: 1447699061
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D2065716
LAB Type Physician Office
Facility Name WEST VININGS PEDIATRIC GROUP, PC
Street 3644 HIGHLANDS PARKWAY
City SMYRNA
State GA
ZIP 30082
Phone 404 446-3960
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/13/2025
Certificate Expiration Date 9/12/2027
Facility Type Physician Office
Lab Director CRYSTAL L. WHITE

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