11D2296629 CLIA NUMBER - MENKE INVESTMENT INC DBA MEDI WEIGHTLOSS WOODSTOCK

Laboratory Demographics

  • CLIA Code: 11D2296629
  • Facility Name: MENKE INVESTMENT INC DBA MEDI WEIGHTLOSS WOODSTOCK
  • Facility Address: 13190 HIGHWAY 92, SUITE 110
    WOODSTOCK, GA
    ZIP 30188
  • Facility Phone: 678 540-7827
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KATHERINE E. WIEGMAN
  • NPI Number: 1023887684
  • Taxonomy: 207RB0002X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2296629
LAB Type Physician Office
Facility Name MENKE INVESTMENT INC DBA MEDI WEIGHTLOSS WOODSTOCK
Street 13190 HIGHWAY 92, SUITE 110
City WOODSTOCK
State GA
ZIP 30188
Phone 678 540-7827
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/3/2024
Certificate Expiration Date 1/2/2026
Facility Type Physician Office
Lab Director KATHERINE E. WIEGMAN

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