11D2314899 CLIA NUMBER - GEORGIA UROLOGY BUFORD

Laboratory Demographics

  • CLIA Code: 11D2314899
  • Facility Name: GEORGIA UROLOGY BUFORD
  • Facility Address: 58 BIG A ROAD
    TOCCOA, GA
    ZIP 30577
  • Facility Phone: 770 219-8765
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: BRENT SHARPE
  • NPI Number: 1023837135
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 11D2314899
LAB Type Physician Office
Facility Name GEORGIA UROLOGY BUFORD
Street 58 BIG A ROAD
City TOCCOA
State GA
ZIP 30577
Phone 770 219-8765
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 12/3/2024
Certificate Expiration Date 12/2/2026
Facility Type Physician Office
Lab Director BRENT SHARPE

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