11D2108530 CLIA NUMBER - GEORGIA UROLOGY

Laboratory Demographics

  • CLIA Code: 11D2108530
  • Facility Name: GEORGIA UROLOGY
  • Facility Address: 2161 WEST SPRING STREET, SUITE C
    MONROE, GA
    ZIP 30655
  • Facility Phone: 678 284-4062
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ANGLADE RONALD
  • NPI Number: 1184089989
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 11D2108530
LAB Type Physician Office
Facility Name GEORGIA UROLOGY
Street 2161 WEST SPRING STREET, SUITE C
City MONROE
State GA
ZIP 30655
Phone 678 284-4062
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/8/2024
Certificate Expiration Date 2/7/2026
Facility Type Physician Office
Lab Director ANGLADE RONALD

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