11D2215004 CLIA NUMBER - SPATIUM URGENT CARE

Laboratory Demographics

  • CLIA Code: 11D2215004
  • Facility Name: SPATIUM URGENT CARE
  • Facility Address: 3595 CANTON ROAD SUITES 314/316
    MARIETTA, GA
    ZIP 30066
  • Facility Phone: 443 803-3372
  • Facility Type: Other - URGENT CARE CENTER
  • Facility Type: Waiver
  • Lab Director: AGHOGHO OMENE
  • NPI Number: 1508453044
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2215004
LAB Type Other - URGENT CARE CENTER
Facility Name SPATIUM URGENT CARE
Street 3595 CANTON ROAD SUITES 314/316
City MARIETTA
State GA
ZIP 30066
Phone 443 803-3372
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/26/2025
Certificate Expiration Date 2/25/2027
Facility Type Other - URGENT CARE CENTER
Lab Director AGHOGHO OMENE

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