11D2235384 CLIA NUMBER - BRIDGEPOINT CLINIC LLC

Laboratory Demographics

  • CLIA Code: 11D2235384
  • Facility Name: BRIDGEPOINT CLINIC LLC
  • Facility Address: 4125 ATLANTA ROAD SUITE 120
    SMYRNA, GA
    ZIP 30080
  • Facility Phone: 770 858-5377
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ARUN KANTAMNENI
  • NPI Number: 1396464483
  • Taxonomy: 2084P0800X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 11D2235384
LAB Type Physician Office
Facility Name BRIDGEPOINT CLINIC LLC
Street 4125 ATLANTA ROAD SUITE 120
City SMYRNA
State GA
ZIP 30080
Phone 770 858-5377
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/9/2025
Certificate Expiration Date 9/8/2027
Facility Type Physician Office
Lab Director ARUN KANTAMNENI

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