11D2140579 CLIA NUMBER - KENNETH E GOOLSBY, MD & ASSOCIATES

Laboratory Demographics

  • CLIA Code: 11D2140579
  • Facility Name: KENNETH E GOOLSBY, MD & ASSOCIATES
  • Facility Address: 1990 LIMESTONE CIRCLE, SUITE 110
    GAINESVILLE, GA
    ZIP 30501
  • Facility Phone: 770 548-7032
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KENNETH E. GOOLSBY
  • NPI Number: 1689783870
  • Taxonomy: 208200000X - Plastic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 11D2140579
LAB Type Physician Office
Facility Name KENNETH E GOOLSBY, MD & ASSOCIATES
Street 1990 LIMESTONE CIRCLE, SUITE 110
City GAINESVILLE
State GA
ZIP 30501
Phone 770 548-7032
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/27/2023
Certificate Expiration Date 11/26/2025
Facility Type Physician Office
Lab Director KENNETH E. GOOLSBY

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