11D0714600 CLIA NUMBER - KIRK A PAULK MD

Laboratory Demographics

  • CLIA Code: 11D0714600
  • Facility Name: KIRK A PAULK MD
  • Facility Address: 5885 GLENRIDGE DRIVE, SUITE 250
    ATLANTA, GA
    ZIP 30328
  • Facility Phone: 404 252-7226
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KIRK A. PAULK
  • NPI Number: 1639191828
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0714600
LAB Type Physician Office
Facility Name KIRK A PAULK MD
Street 5885 GLENRIDGE DRIVE, SUITE 250
City ATLANTA
State GA
ZIP 30328
Phone 404 252-7226
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 KIRK A. PAULK

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