11D0919269 CLIA NUMBER - MEDICAL CENTRE OF CONYERS

Laboratory Demographics

  • CLIA Code: 11D0919269
  • Facility Name: MEDICAL CENTRE OF CONYERS
  • Facility Address: 1445 OLD MCDONOUGH HWY SE SUITE E
    CONYERS, GA
    ZIP 30094
  • Facility Phone: 770 922-9222
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STEPHEN F. FELTON MD
  • NPI Number: 1932379666
  • Taxonomy: 173000000X - Legal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0919269
LAB Type Physician Office
Facility Name MEDICAL CENTRE OF CONYERS
Street 1445 OLD MCDONOUGH HWY SE SUITE E
City CONYERS
State GA
ZIP 30094
Phone 770 922-9222
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/16/2024
Certificate Expiration Date 4/15/2026
Facility Type Physician Office
Lab Director STEPHEN F. FELTON MD

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