CLIA lab
CLIA 11D2004020: Creekside Medical Clinic, LLC
Kennesaw, GA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 11D2004020 belongs to Creekside Medical Clinic, LLC in Kennesaw, GA.
Certificate for Provider-Performed Microscopy Procedures, effective February 24, 2026, expires February 23, 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 for Provider-Performed Microscopy Procedures
- Certificate effective
- February 24, 2026
- Certificate expiration
- February 23, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- February 24, 2010
- 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
- 11D2004020
- Lab name
- Creekside Medical Clinic, LLC
- Address
- 3104 Creekside Village Drive, #201, Kennesaw, GA 30144
- Phone
- (770) 627-3986
- Fax
- (770) 872-0517
Annual test volume the lab reported
- Waived tests
- 100
- Provider-performed microscopy tests
- 30
- Total
- 130
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 Creekside Medical Clinic, LLC in Kennesaw?
11D2004020, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Creekside Medical Clinic, LLC hold?
A Certificate for Provider-Performed Microscopy Procedures, according to the CMS file.
When does CLIA 11D2004020 expire?
The CMS file lists February 23, 2028 as the certificate expiration date; the certificate took effect February 24, 2026.