11D2311084 CLIA NUMBER - V PHYSICIAN SERVICES, LLC

Laboratory Demographics

  • CLIA Code: 11D2311084
  • Facility Name: V PHYSICIAN SERVICES, LLC
  • Facility Address: 1124 N TENNESSEE STREET, SUITE 104
    CARTERSVILLE, GA
    ZIP 30120
  • Facility Phone: 470 684-1448
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: K DINAVAHL LAKSHMAN
  • NPI Number: 1699441162
  • Taxonomy: 207RG0300X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2311084
LAB Type Physician Office
Facility Name V PHYSICIAN SERVICES, LLC
Street 1124 N TENNESSEE STREET, SUITE 104
City CARTERSVILLE
State GA
ZIP 30120
Phone 470 684-1448
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/17/2024
Certificate Expiration Date 9/16/2026
Facility Type Physician Office
Lab Director K DINAVAHL LAKSHMAN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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