CLIA lab
CLIA 11D2091295: Nissi Family Medicine
Austell, GA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 11D2091295 belongs to Nissi Family Medicine in Austell, GA.
Certificate of Waiver, effective February 10, 2025, expires February 9, 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
- February 10, 2025
- Certificate expiration
- February 9, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- February 10, 2015
- 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
- 11D2091295
- Lab name
- Nissi Family Medicine
- Address
- 1810 Mulkey Road, Suite 105, Austell, GA 30106
- Phone
- (678) 540-7597
- Fax
- (770) 485-9802
Annual test volume the lab reported
- Waived tests
- 250
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 Nissi Family Medicine in Austell?
11D2091295, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Nissi Family Medicine hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 11D2091295 expire?
The CMS file lists February 9, 2027 as the certificate expiration date; the certificate took effect February 10, 2025.