11D2136941 CLIA NUMBER - GEORGIA UROLOGY - EAST COBB

Laboratory Demographics

  • CLIA Code: 11D2136941
  • Facility Name: GEORGIA UROLOGY - EAST COBB
  • Facility Address: 4800 OLDE TOWNE PARKWAY, SUITE 220
    MARIETTA, GA
    ZIP 30068
  • Facility Phone: 404 252-8227
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: KRISTI HEBERT
  • NPI Number: 1447772348
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 11D2136941
LAB Type Physician Office
Facility Name GEORGIA UROLOGY - EAST COBB
Street 4800 OLDE TOWNE PARKWAY, SUITE 220
City MARIETTA
State GA
ZIP 30068
Phone 404 252-8227
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 9/19/2023
Certificate Expiration Date 9/18/2025
Facility Type Physician Office
Lab Director KRISTI HEBERT

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This page was last updated on: 6/4/2025