11D0878886 CLIA NUMBER - NEESAM COMPANY INC DBA SOUTH ATLANTA AREA PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 11D0878886
  • Facility Name: NEESAM COMPANY INC DBA SOUTH ATLANTA AREA PRIMARY CARE
  • Facility Address: 777 CLEVELAND AVENUE, SUITE 500
    ATLANTA, GA
    ZIP 30315
  • Facility Phone: 404 755-2291
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: OTIS S. POWELL JR
  • NPI Number: 1376952069
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0878886
LAB Type Physician Office
Facility Name NEESAM COMPANY INC DBA SOUTH ATLANTA AREA PRIMARY CARE
Street 777 CLEVELAND AVENUE, SUITE 500
City ATLANTA
State GA
ZIP 30315
Phone 404 755-2291
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 12/23/2024
Certificate Expiration Date 12/22/2026
Facility Type Physician Office
Lab Director OTIS S. POWELL JR

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