11D2146114 CLIA NUMBER - PRO RADIOLOGY, LLC

Laboratory Demographics

  • CLIA Code: 11D2146114
  • Facility Name: PRO RADIOLOGY, LLC
  • Facility Address: 3921 JOHNS CREEK COURT, SUITE B
    SUWANEE, GA
    ZIP 30024
  • Facility Phone: 770 217-7141
  • Facility Type: Other - OUTPATIENT RADIOLOGY
  • Facility Type: Waiver
  • Lab Director: JESSICA DEMPSEY
  • NPI Number: 1942733308
  • Taxonomy: 261QR0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2146114
LAB Type Other - OUTPATIENT RADIOLOGY
Facility Name PRO RADIOLOGY, LLC
Street 3921 JOHNS CREEK COURT, SUITE B
City SUWANEE
State GA
ZIP 30024
Phone 770 217-7141
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2024
Certificate Expiration Date 3/21/2026
Facility Type Other - OUTPATIENT RADIOLOGY
Lab Director JESSICA DEMPSEY

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