11D2186862 CLIA NUMBER - ADVANCED UROLOGY INSTITUTE OF GEORGIA, PC

Laboratory Demographics

  • CLIA Code: 11D2186862
  • Facility Name: ADVANCED UROLOGY INSTITUTE OF GEORGIA, PC
  • Facility Address: 3075 RONALD REAGEN BOULEVARD SUITE 501
    CUMMING, GA
    ZIP 30041
  • Facility Phone: 770 979-9966
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KUSHAN RADADIA
  • NPI Number: 1700407772
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 11D2186862
LAB Type Physician Office
Facility Name ADVANCED UROLOGY INSTITUTE OF GEORGIA, PC
Street 3075 RONALD REAGEN BOULEVARD SUITE 501
City CUMMING
State GA
ZIP 30041
Phone 770 979-9966
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/23/2024
Certificate Expiration Date 6/22/2026
Facility Type Physician Office
Lab Director KUSHAN RADADIA

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This page was last updated on: 3/20/2025