11D0969768 CLIA NUMBER - KIDS FIRST PEDIATRIC GROUP LLC

Laboratory Demographics

  • CLIA Code: 11D0969768
  • Facility Name: KIDS FIRST PEDIATRIC GROUP LLC
  • Facility Address: 1045 SOUTHCREST DRIVE, SUITE 110
    STOCKBRIDGE, GA
    ZIP 30281
  • Facility Phone: 770 507-2212
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ELAINE C. YOUNGBLOOD
  • NPI Number: 1720117989
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D0969768
LAB Type Physician Office
Facility Name KIDS FIRST PEDIATRIC GROUP LLC
Street 1045 SOUTHCREST DRIVE, SUITE 110
City STOCKBRIDGE
State GA
ZIP 30281
Phone 770 507-2212
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/23/2024
Certificate Expiration Date 9/22/2026
Facility Type Physician Office
Lab Director ELAINE C. YOUNGBLOOD

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