CLIA lab
CLIA 11D1010647: Kennesaw Pediatrics PC
Kennesaw, GA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 11D1010647 belongs to Kennesaw Pediatrics PC in Kennesaw, GA.
Certificate of Waiver, effective June 1, 2025, expires May 31, 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 of Waiver
- Certificate effective
- June 1, 2025
- Certificate expiration
- May 31, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- March 20, 2003
- 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
- 11D1010647
- Lab name
- Kennesaw Pediatrics PC
- Address
- 3745 Cherokee Street, Suite 401, Kennesaw, GA 30144
- Phone
- (770) 429-1005
- Fax
- (770) 429-8005
Annual test volume the lab reported
- Waived tests
- 15,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Any Lab TestCertificate of Waiver, Independent11D1079732
- Biolife Plasma Services, LPCertificate of Compliance, Other11D2219907
- CPG Endocrinology - Town CenterCertificate of Waiver, Physician office11D2141590
- Caresouth HHA Holdings of Gainesville, LLCCertificate of Waiver, Home health agency11D1054345
- Caresouth HHA Holdings of Gainesville,llcCertificate of Waiver, Hospice11D2020212
- Center for Allergy & Asthma of GaCertificate of Waiver, Physician office11D2086701
- Center for Authentic Life & Relationship,llcCertificate of Waiver, Other practitioner11D2316892
Related
Questions
What is the CLIA number for Kennesaw Pediatrics PC in Kennesaw?
11D1010647, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Kennesaw Pediatrics PC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 11D1010647 expire?
The CMS file lists May 31, 2027 as the certificate expiration date; the certificate took effect June 1, 2025.