11D0257792 CLIA NUMBER - SANJEEV S TENDOLKAR MD LLC

Laboratory Demographics

  • CLIA Code: 11D0257792
  • Facility Name: SANJEEV S TENDOLKAR MD LLC
  • Facility Address: 4593 LAWRENCEVILLE ROAD
    LOGANVILLE, GA
    ZIP 30052
  • Facility Phone: 770 466-8672
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SANJEEV S. TENDOLKAR
  • NPI Number: 1326258583
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0257792
LAB Type Physician Office
Facility Name SANJEEV S TENDOLKAR MD LLC
Street 4593 LAWRENCEVILLE ROAD
City LOGANVILLE
State GA
ZIP 30052
Phone 770 466-8672
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director SANJEEV S. TENDOLKAR

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