CLIA lab
CLIA 11D0255764: Village Medical Stone Mountain
Stone Mountain, GA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 11D0255764 belongs to Village Medical Stone Mountain in Stone Mountain, GA.
Certificate for Provider-Performed Microscopy Procedures, effective November 8, 2025, expires November 7, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate for Provider-Performed Microscopy Procedures
- Certificate effective
- November 8, 2025
- Certificate expiration
- November 7, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- September 1, 1992
- Facility type
- Physician office
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 11D0255764
- Lab name
- Village Medical Stone Mountain
- Address
- 5435 Five Forks Trickum Road, Stone Mountain, GA 30087
- Phone
- (770) 469-2372
Annual test volume the lab reported
- Waived tests
- 2,600
- Provider-performed microscopy tests
- 100
- Total
- 2,700
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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Related
Questions
What is the CLIA number for Village Medical Stone Mountain in Stone Mountain?
11D0255764, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Village Medical Stone Mountain hold?
A Certificate for Provider-Performed Microscopy Procedures, according to the CMS file.
When does CLIA 11D0255764 expire?
The CMS file lists November 7, 2027 as the certificate expiration date; the certificate took effect November 8, 2025.