CLIA lab
CLIA 11D0669789: Northside Bogart Primry Care
Bogart, GA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 11D0669789 belongs to Northside Bogart Primry Care in Bogart, GA.
Certificate of Waiver, effective September 1, 2026, expires August 31, 2028.
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 of Waiver
- Certificate effective
- September 1, 2026
- Certificate expiration
- August 31, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- January 6, 1993
- Facility type
- Physician office
- Ownership (control type)
- Private
- 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
- 11D0669789
- Lab name
- Northside Bogart Primry Care
- Address
- 129 Main Street, Bogart, GA 30622
- Phone
- (706) 725-7420
- Fax
- (770) 725-5578
Annual test volume the lab reported
- Waived tests
- 1,200
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Bogart, GA
- Caregap Medfast ClinicCertificate of Waiver, Physician office11D2346925
- Creative Hospice Care, IncorporatedCertificate of Waiver, Hospice11D2025314
- Halifax EMS, LLCCertificate of Waiver, Ambulance11D2260951
- ST Mary's Center for Wound HealingCertificate of Waiver, Other11D2050148
- ST Mary's Family MedicineCertificate of Waiver, Physician office11D2159236
- The Landing of BogartCertificate of Waiver, Other11D2195021
Related
Questions
What is the CLIA number for Northside Bogart Primry Care in Bogart?
11D0669789, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Northside Bogart Primry Care hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 11D0669789 expire?
The CMS file lists August 31, 2028 as the certificate expiration date; the certificate took effect September 1, 2026.