11D0929379 CLIA NUMBER - CAMP CREEK PEDIATRICS

Laboratory Demographics

  • CLIA Code: 11D0929379
  • Facility Name: CAMP CREEK PEDIATRICS
  • Facility Address: 3886 PRINCETON LAKES WAY, SUITE 260
    ATLANTA, GA
    ZIP 30331
  • Facility Phone: 404 349-6758
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. CHARLENE JOHNSON
  • NPI Number: 1891065504
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D0929379
LAB Type Physician Office
Facility Name CAMP CREEK PEDIATRICS
Street 3886 PRINCETON LAKES WAY, SUITE 260
City ATLANTA
State GA
ZIP 30331
Phone 404 349-6758
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/12/2025
Certificate Expiration Date 6/11/2027
Facility Type Physician Office
Lab Director DR. CHARLENE JOHNSON

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