11D0978058 CLIA NUMBER - SUWANEE MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 11D0978058
  • Facility Name: SUWANEE MEDICAL CENTER
  • Facility Address: 960 PEACHTREE INDUSTRIAL BLVD
    SUWANEE, GA
    ZIP 30024
  • Facility Phone: 770 831-8191
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JOHN Y. SHIH
  • NPI Number: 1306026307
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0978058
LAB Type Physician Office
Facility Name SUWANEE MEDICAL CENTER
Street 960 PEACHTREE INDUSTRIAL BLVD
City SUWANEE
State GA
ZIP 30024
Phone 770 831-8191
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/14/2024
Certificate Expiration Date 9/13/2026
Facility Type Physician Office
Lab Director JOHN Y. SHIH

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