11D2299510 CLIA NUMBER - COSMIC PEDIATRICS

Laboratory Demographics

  • CLIA Code: 11D2299510
  • Facility Name: COSMIC PEDIATRICS
  • Facility Address: 61 ROBINSON LAKE ROAD
    NEWNAN, GA
    ZIP 30265
  • Facility Phone: 470 414-1329
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TOREY S. HARDEN
  • NPI Number: 1154185312
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D2299510
LAB Type Physician Office
Facility Name COSMIC PEDIATRICS
Street 61 ROBINSON LAKE ROAD
City NEWNAN
State GA
ZIP 30265
Phone 470 414-1329
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/22/2024
Certificate Expiration Date 2/21/2026
Facility Type Physician Office
Lab Director TOREY S. HARDEN

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