11D2260240 CLIA NUMBER - YOURTOWNDOCTOR, LLC DBA GA/MD

Laboratory Demographics

  • CLIA Code: 11D2260240
  • Facility Name: YOURTOWNDOCTOR, LLC DBA GA/MD
  • Facility Address: 3665 SWIFTWATER PARK DRIVE SUITE 307
    SUWANEE, GA
    ZIP 30024
  • Facility Phone: 470 573-1050
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: KATHERINE WIEGMAN
  • NPI Number: 1750041075
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2260240
LAB Type Practitioner Other
Facility Name YOURTOWNDOCTOR, LLC DBA GA/MD
Street 3665 SWIFTWATER PARK DRIVE SUITE 307
City SUWANEE
State GA
ZIP 30024
Phone 470 573-1050
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/17/2024
Certificate Expiration Date 5/16/2026
Facility Type Practitioner Other
Lab Director KATHERINE WIEGMAN

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