CLIA lab
CLIA 11D2290537: Moultrie Medical PC
Brookhaven, GA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 11D2290537 belongs to Moultrie Medical PC in Brookhaven, GA.
Certificate of Waiver, effective September 27, 2025, expires September 26, 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
- September 27, 2025
- Certificate expiration
- September 26, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- September 27, 2023
- 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
- 11D2290537
- Lab name
- Moultrie Medical PC
- Address
- 2970 Clairmont Road, NE, Suite 210, Brookhaven, GA 30329
- Phone
- (404) 236-9502
- Fax
- (470) 243-0943
Annual test volume the lab reported
- Waived tests
- 100
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Brookhaven, GA
- Brookhaven Lifestance HealthCertificate of Waiver, Physician office11D2274412
- Fp-Peachtree Immediate Care-BhnCertificate of Waiver, Physician office11D2148274
- Georgia CVS Pharmacy, LLC DBA Cvs/Pharmacy #02083Certificate of Waiver, Pharmacy11D2282547
- Georgia Dermatology PartnersCertificate of Compliance, Physician office11D2166267
- Glenn Family Wellness CenterCertificate of Waiver, Other11D1032109
- Intown Pediatric & Adolescent Medicine, PCCertificate of Waiver, Physician office11D2133990
- Intown Pediatric & Adolescent Medicine, PCCertificate of Waiver, Physician office11D2135382
- Mend Primary CareCertificate of Waiver, Physician office11D2344432
- North Dekalb County VA ClinicCertificate of Accreditation, Community clinic11D2183601
- Northside - Primary Care of BrookhavenCertificate for Provider-Performed Microscopy Procedures, Physician office11D2161206
Related
Questions
What is the CLIA number for Moultrie Medical PC in Brookhaven?
11D2290537, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Moultrie Medical PC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 11D2290537 expire?
The CMS file lists September 26, 2027 as the certificate expiration date; the certificate took effect September 27, 2025.