11D2126989 CLIA NUMBER - VILLAGE PODIATRY GROUP, LLC

Laboratory Demographics

  • CLIA Code: 11D2126989
  • Facility Name: VILLAGE PODIATRY GROUP, LLC
  • Facility Address: 550 PEACHTREE STREET, NE, SUITE 1960
    ATLANTA, GA
    ZIP 30308
  • Facility Phone: 678 426-2171
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MOHAMMAD A. SHARIF
  • NPI Number: 1164585964
  • Taxonomy: 213ES0103X - Podiatrist

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CLIA Record

Field Name Field Value
CLIA Number 11D2126989
LAB Type Physician Office
Facility Name VILLAGE PODIATRY GROUP, LLC
Street 550 PEACHTREE STREET, NE, SUITE 1960
City ATLANTA
State GA
ZIP 30308
Phone 678 426-2171
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/8/2025
Certificate Expiration Date 3/7/2027
Facility Type Physician Office
Lab Director MOHAMMAD A. SHARIF

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