11D2330157 CLIA NUMBER - MEDHUB

Laboratory Demographics

  • CLIA Code: 11D2330157
  • Facility Name: MEDHUB
  • Facility Address: 5835 CAMPBELLTON ROAD SW, SUITE 201
    ATLANTA, GA
    ZIP 30331
  • Facility Phone: 404 213-5696
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAVINDRANATH NALLAMOTHU
  • NPI Number: 1912703166
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2330157
LAB Type Physician Office
Facility Name MEDHUB
Street 5835 CAMPBELLTON ROAD SW, SUITE 201
City ATLANTA
State GA
ZIP 30331
Phone 404 213-5696
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/11/2025
Certificate Expiration Date 9/10/2027
Facility Type Physician Office
Lab Director RAVINDRANATH NALLAMOTHU

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