11D0911758 CLIA NUMBER - CONCENTRA - LAWRENCEVILLE

Laboratory Demographics

  • CLIA Code: 11D0911758
  • Facility Name: CONCENTRA - LAWRENCEVILLE
  • Facility Address: 755 LAWRENCEVLLE SUWANEE ROAD SUITE 1600
    LAWRENCEVILLE, GA
    ZIP 30043
  • Facility Phone: 770 995-1500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SATEESH DEVAGUPTHAPU
  • NPI Number: 1780876375
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D0911758
LAB Type Physician Office
Facility Name CONCENTRA - LAWRENCEVILLE
Street 755 LAWRENCEVLLE SUWANEE ROAD SUITE 1600
City LAWRENCEVILLE
State GA
ZIP 30043
Phone 770 995-1500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/26/2024
Certificate Expiration Date 10/25/2026
Facility Type Physician Office
Lab Director SATEESH DEVAGUPTHAPU

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