11D2163290 CLIA NUMBER - PATRICK D RETTERBUSH, MD, LLC

Laboratory Demographics

  • CLIA Code: 11D2163290
  • Facility Name: PATRICK D RETTERBUSH, MD, LLC
  • Facility Address: 1500 OGELTHORPE AVENUE, SUITE 300 A
    ATHENS, GA
    ZIP 30606
  • Facility Phone: 706 614-1750
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: PATRICK D. RETTERBUSH
  • NPI Number: 1700176211
  • Taxonomy: 207ND0101X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 11D2163290
LAB Type Physician Office
Facility Name PATRICK D RETTERBUSH, MD, LLC
Street 1500 OGELTHORPE AVENUE, SUITE 300 A
City ATHENS
State GA
ZIP 30606
Phone 706 614-1750
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 11/12/2023
Certificate Expiration Date 11/11/2025
Facility Type Physician Office
Lab Director PATRICK D. RETTERBUSH

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