11D2139250 CLIA NUMBER - GEORGIA UROLOGY - CUMMING ASC

Laboratory Demographics

  • CLIA Code: 11D2139250
  • Facility Name: GEORGIA UROLOGY - CUMMING ASC
  • Facility Address: 4150 DEPUTY BILL CANTRELL MEMORIAL ROAD, STE 140A
    CUMMING, GA
    ZIP 30040
  • Facility Phone: 404 256-1844
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Microscopy
  • Lab Director: LEWIS KRITEMAN
  • NPI Number: 1639538861
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 11D2139250
LAB Type Ambulatory Surgery Center
Facility Name GEORGIA UROLOGY - CUMMING ASC
Street 4150 DEPUTY BILL CANTRELL MEMORIAL ROAD, STE 140A
City CUMMING
State GA
ZIP 30040
Phone 404 256-1844
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 11/3/2023
Certificate Expiration Date 11/2/2025
Facility Type Ambulatory Surgery Center
Lab Director LEWIS KRITEMAN

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