11D2276671 CLIA NUMBER - WILLIS CHIROPRACTIC CENTER

Laboratory Demographics

  • CLIA Code: 11D2276671
  • Facility Name: WILLIS CHIROPRACTIC CENTER
  • Facility Address: 2829 DALLAS STREET
    KENNESAW, GA
    ZIP 30144
  • Facility Phone: 770 429-0707
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JUSTIN WILLIS
  • NPI Number: 1790971240
  • Taxonomy: 111N00000X - Chiropractor

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CLIA Record

Field Name Field Value
CLIA Number 11D2276671
LAB Type Physician Office
Facility Name WILLIS CHIROPRACTIC CENTER
Street 2829 DALLAS STREET
City KENNESAW
State GA
ZIP 30144
Phone 770 429-0707
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/14/2025
Certificate Expiration Date 2/13/2027
Facility Type Physician Office
Lab Director JUSTIN WILLIS

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