11D2274493 CLIA NUMBER - CENTRO PRENATAL DE GEORGIA

Laboratory Demographics

  • CLIA Code: 11D2274493
  • Facility Name: CENTRO PRENATAL DE GEORGIA
  • Facility Address: 5195 JIMMY CARTER BLVD, SUITE 100
    NORCROSS, GA
    ZIP 30093
  • Facility Phone: 470 514-5818
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROSALBA GOMEZ
  • NPI Number: 1780254201
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 11D2274493
LAB Type Physician Office
Facility Name CENTRO PRENATAL DE GEORGIA
Street 5195 JIMMY CARTER BLVD, SUITE 100
City NORCROSS
State GA
ZIP 30093
Phone 470 514-5818
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/5/2025
Certificate Expiration Date 1/4/2027
Facility Type Physician Office
Lab Director ROSALBA GOMEZ

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