11D0692396 CLIA NUMBER - NORTH FULTON PEDIATRICS PC

Laboratory Demographics

  • CLIA Code: 11D0692396
  • Facility Name: NORTH FULTON PEDIATRICS PC
  • Facility Address: 1285 HEMBREE RD SUITE 100
    ROSWELL, GA
    ZIP 30076
  • Facility Phone: 770 442-1050
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GERALD H. CLARK
  • NPI Number: 1083669063
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D0692396
LAB Type Physician Office
Facility Name NORTH FULTON PEDIATRICS PC
Street 1285 HEMBREE RD SUITE 100
City ROSWELL
State GA
ZIP 30076
Phone 770 442-1050
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/15/2025
Certificate Expiration Date 7/14/2027
Facility Type Physician Office
Lab Director GERALD H. CLARK

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