11D2244111 CLIA NUMBER - MEDI WEIGHTLOSS

Laboratory Demographics

  • CLIA Code: 11D2244111
  • Facility Name: MEDI WEIGHTLOSS
  • Facility Address: 277 HIGHWAY 74 N, SUITE 210
    PEACHTREE CITY, GA
    ZIP 30269
  • Facility Phone: 770 628-5660
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: KATHERINE WIEGMAN
  • NPI Number: 1609534114
  • Taxonomy: 207RB0002X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2244111
LAB Type Practitioner Other
Facility Name MEDI WEIGHTLOSS
Street 277 HIGHWAY 74 N, SUITE 210
City PEACHTREE CITY
State GA
ZIP 30269
Phone 770 628-5660
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/29/2023
Certificate Expiration Date 11/28/2025
Facility Type Practitioner Other
Lab Director KATHERINE WIEGMAN

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