11D0960900 CLIA NUMBER - EAGLES LANDING PEDIATRIC ASSOCIATES LLC

Laboratory Demographics

  • CLIA Code: 11D0960900
  • Facility Name: EAGLES LANDING PEDIATRIC ASSOCIATES LLC
  • Facility Address: 1101 HOSPITAL DRIVE, SUITE 210
    STOCKBRIDGE, GA
    ZIP 30281
  • Facility Phone: 678 289-0103
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STEVEN W. LEARD
  • NPI Number: 1740407550
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D0960900
LAB Type Physician Office
Facility Name EAGLES LANDING PEDIATRIC ASSOCIATES LLC
Street 1101 HOSPITAL DRIVE, SUITE 210
City STOCKBRIDGE
State GA
ZIP 30281
Phone 678 289-0103
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/24/2025
Certificate Expiration Date 5/23/2027
Facility Type Physician Office
Lab Director STEVEN W. LEARD

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