CLIA lab
CLIA 11D2130830: Wellstar Primary Care at the Pavilion
Hiram, GA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 11D2130830 belongs to Wellstar Primary Care at the Pavilion in Hiram, GA.
Certificate of Waiver, effective May 18, 2025, expires May 17, 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 18, 2025
- Certificate expiration
- May 17, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- May 18, 2017
- Facility type
- Physician office
- Ownership (control type)
- Private
- Lab classification
- CLIA laboratory
- Directly affiliated labs
- 1
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 11D2130830
- Lab name
- Wellstar Primary Care at the Pavilion
- Address
- 148 Bill Carruth Parkway, Suite 300, Hiram, GA 30141
- Phone
- (678) 945-8200
- Fax
- (770) 505-3638
Annual test volume the lab reported
- Waived tests
- 400
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Affiliated CLIA numbers
Other labs in Hiram, GA
- Aga LLCCertificate of Waiver, Physician office11D1085041
- American Health Imaging of HiramCertificate of Waiver, Independent11D2125729
- Atlanta Kidney and Hypertension AssociatesCertificate for Provider-Performed Microscopy Procedures, Physician office11D1095730
- Center for Allergy and Asthma of West Ga, PCCertificate of Waiver, Physician office11D2007451
- Children's Medical Associate, LLCCertificate of Waiver, Physician office11D0254146
- Cobbwest Internal Medicine Associates, LLCCertificate of Waiver, Physician office11D2059133
- FP- Peachtree Immediate Care - HirCertificate of Waiver, Physician office11D1043488
- Fresenius Medical Care HiramCertificate of Waiver, End stage renal disease dialysis facility11D2008298
- Georgia Kidney Associates, IncCertificate for Provider-Performed Microscopy Procedures, Physician office11D2230320
- Georgia Pain and Spine Solutions, PCCertificate of Waiver, Physician office11D2154585
Related
Questions
What is the CLIA number for Wellstar Primary Care at the Pavilion in Hiram?
11D2130830, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Wellstar Primary Care at the Pavilion hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 11D2130830 expire?
The CMS file lists May 17, 2027 as the certificate expiration date; the certificate took effect May 18, 2025.