11D2139933 CLIA NUMBER - NORTHSIDE - CARDIOVASCULR GROUP (DULUTH)

Laboratory Demographics

  • CLIA Code: 11D2139933
  • Facility Name: NORTHSIDE - CARDIOVASCULR GROUP (DULUTH)
  • Facility Address: 3855 PLEASANT HILL ROAD, SUITE 250
    DULUTH, GA
    ZIP 30096
  • Facility Phone: 770 858-1658
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ROMM PHILLIP
  • NPI Number: 1790715381
  • Taxonomy: 282N00000X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 11D2139933
LAB Type Pharmacy
Facility Name NORTHSIDE - CARDIOVASCULR GROUP (DULUTH)
Street 3855 PLEASANT HILL ROAD, SUITE 250
City DULUTH
State GA
ZIP 30096
Phone 770 858-1658
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/13/2023
Certificate Expiration Date 11/12/2025
Facility Type Pharmacy
Lab Director ROMM PHILLIP

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