11D2131836 CLIA NUMBER - GEORGIA UROLOGY - GAINESVILLE

Laboratory Demographics

  • CLIA Code: 11D2131836
  • Facility Name: GEORGIA UROLOGY - GAINESVILLE
  • Facility Address: 961 SMOKY MOUNTAIN SPRINGS LANE, NE
    GAINESVILLE, GA
    ZIP 30501
  • Facility Phone: 678 284-4062
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: BRENT A. SHARPE
  • NPI Number: 1851826036
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 11D2131836
LAB Type Physician Office
Facility Name GEORGIA UROLOGY - GAINESVILLE
Street 961 SMOKY MOUNTAIN SPRINGS LANE, NE
City GAINESVILLE
State GA
ZIP 30501
Phone 678 284-4062
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 6/7/2025
Certificate Expiration Date 6/6/2027
Facility Type Physician Office
Lab Director BRENT A. SHARPE

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