11D2285565 CLIA NUMBER - NORTHSIDE ADVANCED GYNECOLOGIC SURGERY

Laboratory Demographics

  • CLIA Code: 11D2285565
  • Facility Name: NORTHSIDE ADVANCED GYNECOLOGIC SURGERY
  • Facility Address: 500 MEDICAL CENTER BOULEVARD, SUITE 390
    LAWRENCEVILLE, GA
    ZIP 30046
  • Facility Phone: 470 325-1800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WHITNEY BARNES
  • NPI Number: 1952340994
  • Taxonomy: 282N00000X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 11D2285565
LAB Type Physician Office
Facility Name NORTHSIDE ADVANCED GYNECOLOGIC SURGERY
Street 500 MEDICAL CENTER BOULEVARD, SUITE 390
City LAWRENCEVILLE
State GA
ZIP 30046
Phone 470 325-1800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/14/2025
Certificate Expiration Date 7/13/2027
Facility Type Physician Office
Lab Director WHITNEY BARNES

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