11D0257066 CLIA NUMBER - CONCENTRA MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 11D0257066
  • Facility Name: CONCENTRA MEDICAL CENTER
  • Facility Address: 1680 HIGHWAY 138
    CONYERS, GA
    ZIP 30013
  • Facility Phone: 770 760-0066
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TYRONE BUTLER
  • NPI Number: 1992997571
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D0257066
LAB Type Physician Office
Facility Name CONCENTRA MEDICAL CENTER
Street 1680 HIGHWAY 138
City CONYERS
State GA
ZIP 30013
Phone 770 760-0066
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2024
Certificate Expiration Date 10/27/2026
Facility Type Physician Office
Lab Director TYRONE BUTLER

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