11D2297664 CLIA NUMBER - COBB OUTPATIENT DETOX

Laboratory Demographics

  • CLIA Code: 11D2297664
  • Facility Name: COBB OUTPATIENT DETOX
  • Facility Address: 811 LIVINGSTON COURT, SUITE B
    MARIETTA, GA
    ZIP 30067
  • Facility Phone: 470 289-9400
  • Facility Type: Other - OUTPATIENT DETOX
  • Facility Type: Waiver
  • Lab Director: SHARIFF MARTIN
  • NPI Number: 1871276105
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2297664
LAB Type Other - OUTPATIENT DETOX
Facility Name COBB OUTPATIENT DETOX
Street 811 LIVINGSTON COURT, SUITE B
City MARIETTA
State GA
ZIP 30067
Phone 470 289-9400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/19/2024
Certificate Expiration Date 1/18/2026
Facility Type Other - OUTPATIENT DETOX
Lab Director SHARIFF MARTIN

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