11D2127375 CLIA NUMBER - NORTHSIDE HOSPITAL, INC / UROGYNECOLOGY

Laboratory Demographics

  • CLIA Code: 11D2127375
  • Facility Name: NORTHSIDE HOSPITAL, INC / UROGYNECOLOGY
  • Facility Address: 11975 MORRIS ROAD, SUITE 140
    ALPHARETTA, GA
    ZIP 30005
  • Facility Phone: 770 475-4499
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT D. MOORE
  • NPI Number: 1679572861
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 11D2127375
LAB Type Physician Office
Facility Name NORTHSIDE HOSPITAL, INC / UROGYNECOLOGY
Street 11975 MORRIS ROAD, SUITE 140
City ALPHARETTA
State GA
ZIP 30005
Phone 770 475-4499
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/14/2025
Certificate Expiration Date 3/13/2027
Facility Type Physician Office
Lab Director ROBERT D. MOORE

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