11D2121275 CLIA NUMBER - WELLSTAR CORPORATE MEDICINE AT TIP TOP

Laboratory Demographics

  • CLIA Code: 11D2121275
  • Facility Name: WELLSTAR CORPORATE MEDICINE AT TIP TOP
  • Facility Address: 327 WALLACE ROAD
    MARIETTA, GA
    ZIP 30062
  • Facility Phone: 678 486-5574
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MITZI RUBIN
  • NPI Number: 1649247974
  • Taxonomy: 282N00000X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 11D2121275
LAB Type Physician Office
Facility Name WELLSTAR CORPORATE MEDICINE AT TIP TOP
Street 327 WALLACE ROAD
City MARIETTA
State GA
ZIP 30062
Phone 678 486-5574
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/5/2025
Certificate Expiration Date 3/4/2027
Facility Type Physician Office
Lab Director MITZI RUBIN

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