11D2308483 CLIA NUMBER - 360 UROLOGY

Laboratory Demographics

  • CLIA Code: 11D2308483
  • Facility Name: 360 UROLOGY
  • Facility Address: 175 COUNTRY CLUB DRIVE, SUITE 300-E
    STOCKBRIDGE, GA
    ZIP 30281
  • Facility Phone: 678 941-4140
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BHAVIK B. SHAH
  • NPI Number: 1871336669
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 11D2308483
LAB Type Physician Office
Facility Name 360 UROLOGY
Street 175 COUNTRY CLUB DRIVE, SUITE 300-E
City STOCKBRIDGE
State GA
ZIP 30281
Phone 678 941-4140
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/30/2024
Certificate Expiration Date 7/29/2026
Facility Type Physician Office
Lab Director BHAVIK B. SHAH

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