11D2266240 CLIA NUMBER - GEORGIA UROLOGY

Laboratory Demographics

  • CLIA Code: 11D2266240
  • Facility Name: GEORGIA UROLOGY
  • Facility Address: 4330 HIGHLAND PKWY, SUITE 102
    ELLIJAY, GA
    ZIP 30540
  • Facility Phone: 678 284-4686
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: WARREN W. LUDWIG
  • NPI Number: 1699328369
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2266240
LAB Type Physician Office
Facility Name GEORGIA UROLOGY
Street 4330 HIGHLAND PKWY, SUITE 102
City ELLIJAY
State GA
ZIP 30540
Phone 678 284-4686
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/9/2024
Certificate Expiration Date 8/8/2026
Facility Type Physician Office
Lab Director WARREN W. LUDWIG

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