11D2308016 CLIA NUMBER - ADVANCED GYNECOLOGY, PC

Laboratory Demographics

  • CLIA Code: 11D2308016
  • Facility Name: ADVANCED GYNECOLOGY, PC
  • Facility Address: 1366 WELLBROOK CIR, NE, STE B
    CONYERS, GA
    ZIP 30012
  • Facility Phone: 678 344-8900
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LINA M. MILLAN
  • NPI Number: 1093296824
  • Taxonomy: 207VF0040X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 11D2308016
LAB Type Physician Office
Facility Name ADVANCED GYNECOLOGY, PC
Street 1366 WELLBROOK CIR, NE, STE B
City CONYERS
State GA
ZIP 30012
Phone 678 344-8900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/19/2024
Certificate Expiration Date 7/18/2026
Facility Type Physician Office
Lab Director LINA M. MILLAN

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