11D2312892 CLIA NUMBER - WELLSTAR GYNECOLOGIC ONCOLOGY VHP

Laboratory Demographics

  • CLIA Code: 11D2312892
  • Facility Name: WELLSTAR GYNECOLOGIC ONCOLOGY VHP
  • Facility Address: 4441 ATLANTA ROAD, SUITE 319
    SMYRNA, GA
    ZIP 30080
  • Facility Phone: 770 792-6262
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TYLER WOODARD
  • NPI Number: 1669815817
  • Taxonomy: 207VX0201X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 11D2312892
LAB Type Physician Office
Facility Name WELLSTAR GYNECOLOGIC ONCOLOGY VHP
Street 4441 ATLANTA ROAD, SUITE 319
City SMYRNA
State GA
ZIP 30080
Phone 770 792-6262
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/21/2024
Certificate Expiration Date 10/20/2026
Facility Type Physician Office
Lab Director TYLER WOODARD

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