CLIA lab
CLIA 11D2325593: PPG Medical Park Drive
Austell, GA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 11D2325593 belongs to PPG Medical Park Drive in Austell, GA.
Certificate of Waiver, effective June 17, 2025, expires June 16, 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
- June 17, 2025
- Certificate expiration
- June 16, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- June 17, 2025
- 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
- 11D2325593
- Lab name
- PPG Medical Park Drive
- Address
- 3820 Medical Park Drive, Suite 1100, Attn Jane Tyson, Austell, GA 30106
- Phone
- (770) 874-0692
- Fax
- (770) 916-7528
Annual test volume the lab reported
- Waived tests
- 6,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Atlanta West Dermatology PCCertificate of Compliance, Physician office11D0724381
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- Austell CbocCertificate of Accreditation, Community clinic11D1008807
Related
Questions
What is the CLIA number for PPG Medical Park Drive in Austell?
11D2325593, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does PPG Medical Park Drive hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 11D2325593 expire?
The CMS file lists June 16, 2027 as the certificate expiration date; the certificate took effect June 17, 2025.