11D2185143 CLIA NUMBER - SERENITY GYNECOLOGY, LLC

Laboratory Demographics

  • CLIA Code: 11D2185143
  • Facility Name: SERENITY GYNECOLOGY, LLC
  • Facility Address: 300 GLYNN STREET SOUTH
    FAYETTEVILLE, GA
    ZIP 30214
  • Facility Phone: 770 629-2702
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TRACEY L. ST JULIAN
  • NPI Number: 1295360949
  • Taxonomy: 207VG0400X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 11D2185143
LAB Type Physician Office
Facility Name SERENITY GYNECOLOGY, LLC
Street 300 GLYNN STREET SOUTH
City FAYETTEVILLE
State GA
ZIP 30214
Phone 770 629-2702
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/29/2024
Certificate Expiration Date 5/28/2026
Facility Type Physician Office
Lab Director TRACEY L. ST JULIAN

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