11D0716116 CLIA NUMBER - PACES FERRY MEDICAL GROUP PC

Laboratory Demographics

  • CLIA Code: 11D0716116
  • Facility Name: PACES FERRY MEDICAL GROUP PC
  • Facility Address: 3193 HOWELL MILL RD STE 223
    ATLANTA, GA
    ZIP 30327
  • Facility Phone: 404 351-5262
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TIMOTHY A. YOUNG
  • NPI Number: 1497827844
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0716116
LAB Type Physician Office
Facility Name PACES FERRY MEDICAL GROUP PC
Street 3193 HOWELL MILL RD STE 223
City ATLANTA
State GA
ZIP 30327
Phone 404 351-5262
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 TIMOTHY A. YOUNG

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