11D2129250 CLIA NUMBER - PRO RADIOLOGY, LLC

Laboratory Demographics

  • CLIA Code: 11D2129250
  • Facility Name: PRO RADIOLOGY, LLC
  • Facility Address: 60 PEACHTREE PARK DRIVE, NE, SUITE 100
    ATLANTA, GA
    ZIP 30309
  • Facility Phone: 678 278-8800
  • Facility Type: Other - OUTPATIENT RADIOLOGY
  • Facility Type: Waiver
  • Lab Director: DARA JONES
  • NPI Number: 1164966461
  • Taxonomy: 261QR0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2129250
LAB Type Other - OUTPATIENT RADIOLOGY
Facility Name PRO RADIOLOGY, LLC
Street 60 PEACHTREE PARK DRIVE, NE, SUITE 100
City ATLANTA
State GA
ZIP 30309
Phone 678 278-8800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/17/2025
Certificate Expiration Date 4/16/2027
Facility Type Other - OUTPATIENT RADIOLOGY
Lab Director DARA JONES

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