11D2298343 CLIA NUMBER - ATLANTA HEALTH CENTER PC

Laboratory Demographics

  • CLIA Code: 11D2298343
  • Facility Name: ATLANTA HEALTH CENTER PC
  • Facility Address: 4905 LAVISTA ROAD, SUITE B
    TUCKER, GA
    ZIP 30084
  • Facility Phone: 770 680-5740
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: OHAD KOTT
  • NPI Number: 1063110328
  • Taxonomy: 261QP3300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2298343
LAB Type Physician Office
Facility Name ATLANTA HEALTH CENTER PC
Street 4905 LAVISTA ROAD, SUITE B
City TUCKER
State GA
ZIP 30084
Phone 770 680-5740
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/1/2024
Certificate Expiration Date 1/31/2026
Facility Type Physician Office
Lab Director OHAD KOTT

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This page was last updated on: 3/20/2025