11D2290307 CLIA NUMBER - NORTHSIDE TOTAL JOINT SPECIALISTS (ATLANTA)

Laboratory Demographics

CLIA Number: 11D2290307

Facility Name: NORTHSIDE TOTAL JOINT SPECIALISTS (ATLANTA)

Facility Address:
1150 HAMMOND DRIVE, SUITE 400
SANDY SPRINGS, GA
ZIP 30328
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Facility Phone Number: 770 292-6500

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1508047846

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	11D2290307
LAB Type	Physician Office
Facility Name	NORTHSIDE TOTAL JOINT SPECIALISTS (ATLANTA)
Street	1150 HAMMOND DRIVE, SUITE 400
City	SANDY SPRINGS
State	GA
ZIP	30328
Phone	770 292-6500
CertificateType	4
CertificateEffectiveDate	9/24/2023
CertificateExpirationDate	9/23/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024