11D2167337 CLIA NUMBER - ATLANTA COSMETIC

Laboratory Demographics

  • CLIA Code: 11D2167337
  • Facility Name: ATLANTA COSMETIC
  • Facility Address: 371 E PACES FERRY ROAD, #550
    ATLANTA, GA
    ZIP 30305
  • Facility Phone: (404) 400-3120
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TARIQ HAKKY
  • NPI Number: 1427722115
  • Taxonomy: 207L00000X - Anesthesiology

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CLIA Record

Field Name Field Value
CLIA Number 11D2167337
LAB Type Physician Office
Facility Name ATLANTA COSMETIC
Street 371 E PACES FERRY ROAD, #550
City ATLANTA
State GA
ZIP 30305
Phone 4044003120
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/6/2025
Certificate Expiration Date 6/5/2027
Facility Type Physician Office
Lab Director TARIQ HAKKY

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This page was last updated on: 5/18/2026