11D0263518 CLIA NUMBER - AJAY KUMAR MD LLC DBA EATONTON MEDICAL & SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 11D0263518
  • Facility Name: AJAY KUMAR MD LLC DBA EATONTON MEDICAL & SURGERY CENTER
  • Facility Address: 132 SPARTA HIGHWAY
    EATONTON, GA
    ZIP 31024
  • Facility Phone: 770 485-8495
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: AJAY KUMAR MD
  • NPI Number: 1073500443
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0263518
LAB Type Practitioner Other
Facility Name AJAY KUMAR MD LLC DBA EATONTON MEDICAL & SURGERY CENTER
Street 132 SPARTA HIGHWAY
City EATONTON
State GA
ZIP 31024
Phone 770 485-8495
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/5/2024
Certificate Expiration Date 1/4/2026
Facility Type Practitioner Other
Lab Director AJAY KUMAR MD

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