11D0256595 CLIA NUMBER - PERISSEIA PHYSICIANS LLC

Laboratory Demographics

  • CLIA Code: 11D0256595
  • Facility Name: PERISSEIA PHYSICIANS LLC
  • Facility Address: 1655 LEBANON RD STE A
    LAWRENCEVILLE, GA
    ZIP 30043
  • Facility Phone: 770 682-2024
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAVID W. KUNZ
  • NPI Number: 1992868855
  • Taxonomy: 173000000X - Legal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0256595
LAB Type Physician Office
Facility Name PERISSEIA PHYSICIANS LLC
Street 1655 LEBANON RD STE A
City LAWRENCEVILLE
State GA
ZIP 30043
Phone 770 682-2024
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/14/2024
Certificate Expiration Date 2/13/2026
Facility Type Physician Office
Lab Director DAVID W. KUNZ

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