11D2328192 CLIA NUMBER - INNOVATIVE THERAPY GROUP

Laboratory Demographics

  • CLIA Code: 11D2328192
  • Facility Name: INNOVATIVE THERAPY GROUP
  • Facility Address: 690 THORNTON WAY, SUITE A
    LITHIA SPRINGS, GA
    ZIP 30122
  • Facility Phone: 404 290-6786
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: NATALIE BOONER
  • NPI Number: 1154193142
  • Taxonomy: 261QM0801X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2328192
LAB Type Community Clinic
Facility Name INNOVATIVE THERAPY GROUP
Street 690 THORNTON WAY, SUITE A
City LITHIA SPRINGS
State GA
ZIP 30122
Phone 404 290-6786
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/6/2025
Certificate Expiration Date 8/5/2027
Facility Type Community Clinic
Lab Director NATALIE BOONER

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