11D2122980 CLIA NUMBER - CENTRE SPRING MD

Laboratory Demographics

  • CLIA Code: 11D2122980
  • Facility Name: CENTRE SPRING MD
  • Facility Address: 10220 MEDLOCK BRIDGE ROAD
    JOHNS CREEK, GA
    ZIP 30022
  • Facility Phone: 404 814-9808
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: TASNEEM BHATIA
  • NPI Number: 1831553163
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2122980
LAB Type Physician Office
Facility Name CENTRE SPRING MD
Street 10220 MEDLOCK BRIDGE ROAD
City JOHNS CREEK
State GA
ZIP 30022
Phone 404 814-9808
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 12/12/2024
Certificate Expiration Date 12/11/2026
Facility Type Physician Office
Lab Director TASNEEM BHATIA

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