CLIA lab
CLIA 11D1099359: Kennesaw Mountain Medical Grap
Kennesaw, GA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 11D1099359 belongs to Kennesaw Mountain Medical Grap in Kennesaw, GA.
Certificate of Waiver, effective May 12, 2025, expires May 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
- May 12, 2025
- Certificate expiration
- May 11, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- May 12, 2009
- 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
- 11D1099359
- Lab name
- Kennesaw Mountain Medical Grap
- Address
- 1600 Kennesaw Due West Building 600 Suite 625, Kennesaw, GA 30152
- Phone
- (770) 422-5880
Annual test volume the lab reported
- Waived tests
- 10,000
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 Kennesaw Mountain Medical Grap in Kennesaw?
11D1099359, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Kennesaw Mountain Medical Grap hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 11D1099359 expire?
The CMS file lists May 11, 2027 as the certificate expiration date; the certificate took effect May 12, 2025.