11D2285461 CLIA NUMBER - GEORGIA DERMATOLOGY PARTNERS

Laboratory Demographics

  • CLIA Code: 11D2285461
  • Facility Name: GEORGIA DERMATOLOGY PARTNERS
  • Facility Address: 1515 RIVER PLACE, SUITE 300/360
    BRASELTON, GA
    ZIP 30517
  • Facility Phone: 770 942-4845
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JONATHAN WEISS
  • NPI Number: 1548158447
  • Taxonomy: 1223G0001X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 11D2285461
LAB Type Physician Office
Facility Name GEORGIA DERMATOLOGY PARTNERS
Street 1515 RIVER PLACE, SUITE 300/360
City BRASELTON
State GA
ZIP 30517
Phone 770 942-4845
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 7/12/2025
Certificate Expiration Date 7/11/2027
Facility Type Physician Office
Lab Director JONATHAN WEISS

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