CLIA lab
CLIA 11D1058502: Intown Pediatric and Adolescent Medicine PC
Atlanta, GA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 11D1058502 belongs to Intown Pediatric and Adolescent Medicine PC in Atlanta, GA.
Certificate of Waiver, effective August 12, 2025, expires August 11, 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
- August 12, 2025
- Certificate expiration
- August 11, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- September 7, 2006
- 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
- 11D1058502
- Lab name
- Intown Pediatric and Adolescent Medicine PC
- Address
- 490 Bill Kennedy Way, Suite 101, Atlanta, GA 30316
- Phone
- (404) 446-4726
- Fax
- (404) 446-4727
Annual test volume the lab reported
- Waived tests
- 5,000
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 Intown Pediatric and Adolescent Medicine PC in Atlanta?
11D1058502, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Intown Pediatric and Adolescent Medicine PC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 11D1058502 expire?
The CMS file lists August 11, 2027 as the certificate expiration date; the certificate took effect August 12, 2025.