11D0254594 CLIA NUMBER - SOUTH DEKALB PEDIATRICS PC

Laboratory Demographics

  • CLIA Code: 11D0254594
  • Facility Name: SOUTH DEKALB PEDIATRICS PC
  • Facility Address: 2855 CANDLER RD NE SUITE 9
    DECATUR, GA
    ZIP 30034
  • Facility Phone: 404 243-9630
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: RUNETTE FLOWERS
  • NPI Number: 1881727493
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D0254594
LAB Type Physician Office
Facility Name SOUTH DEKALB PEDIATRICS PC
Street 2855 CANDLER RD NE SUITE 9
City DECATUR
State GA
ZIP 30034
Phone 404 243-9630
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/22/2025
Certificate Expiration Date 2/21/2027
Facility Type Physician Office
Lab Director RUNETTE FLOWERS

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This page was last updated on: 9/29/2025