11D2288143 CLIA NUMBER - PIEDMONT VIP

Laboratory Demographics

  • CLIA Code: 11D2288143
  • Facility Name: PIEDMONT VIP
  • Facility Address: 105 COLLIER ROAD, SUITE 5000
    ATLANTA, GA
    ZIP 30309
  • Facility Phone: 404 609-5566
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHARLES ANDREW BROWN
  • NPI Number: 1922047893
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 11D2288143
LAB Type Physician Office
Facility Name PIEDMONT VIP
Street 105 COLLIER ROAD, SUITE 5000
City ATLANTA
State GA
ZIP 30309
Phone 404 609-5566
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/22/2025
Certificate Expiration Date 8/21/2027
Facility Type Physician Office
Lab Director CHARLES ANDREW BROWN

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