11D2195983 CLIA NUMBER - MOORE DIAGNOSTIC LABORATORY, INC

Laboratory Demographics

  • CLIA Code: 11D2195983
  • Facility Name: MOORE DIAGNOSTIC LABORATORY, INC
  • Facility Address: 5590 MABLETON PARKWAY, SUITE 174
    MABLETON, GA
    ZIP 30126
  • Facility Phone: 678 540-6620
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: MARLENE MOORE
  • NPI Number: 1629677034
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2195983
LAB Type Independent
Facility Name MOORE DIAGNOSTIC LABORATORY, INC
Street 5590 MABLETON PARKWAY, SUITE 174
City MABLETON
State GA
ZIP 30126
Phone 678 540-6620
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/15/2025
Certificate Expiration Date 3/14/2027
Facility Type Independent
Lab Director MARLENE MOORE

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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