11D2275421 CLIA NUMBER - ATLANTA NEUROLOGY

Laboratory Demographics

  • CLIA Code: 11D2275421
  • Facility Name: ATLANTA NEUROLOGY
  • Facility Address: 5673 PEACHTREE DUNWOODY ROAD
    ATLANTA, GA
    ZIP 30342
  • Facility Phone: 404 256-7759
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MATTHEWS GWYNN
  • NPI Number: 1982823506
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 11D2275421
LAB Type Physician Office
Facility Name ATLANTA NEUROLOGY
Street 5673 PEACHTREE DUNWOODY ROAD
City ATLANTA
State GA
ZIP 30342
Phone 404 256-7759
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/23/2025
Certificate Expiration Date 1/22/2027
Facility Type Physician Office
Lab Director MATTHEWS GWYNN

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