11D2171334 CLIA NUMBER - ONE MEDICAL-MARIETTA

Laboratory Demographics

  • CLIA Code: 11D2171334
  • Facility Name: ONE MEDICAL-MARIETTA
  • Facility Address: 280 COBB PARKWAY, SE, SUITE 60
    MARIETTA, GA
    ZIP 30060
  • Facility Phone: 678 820-7373
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHANGEETHA BALAKUMAR
  • NPI Number: 1184283772
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2171334
LAB Type Physician Office
Facility Name ONE MEDICAL-MARIETTA
Street 280 COBB PARKWAY, SE, SUITE 60
City MARIETTA
State GA
ZIP 30060
Phone 678 820-7373
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/29/2025
Certificate Expiration Date 8/28/2027
Facility Type Physician Office
Lab Director SHANGEETHA BALAKUMAR

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