11D0987106 CLIA NUMBER - WELLSTAR ACWORTH FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 11D0987106
  • Facility Name: WELLSTAR ACWORTH FAMILY PRACTICE
  • Facility Address: 4550 COBB PARKWAY, NORTH, SUITE 201 A
    ACWORTH, GA
    ZIP 30101
  • Facility Phone: 770 974-4655
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOHN N. MURIMI
  • NPI Number: 1821352964
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0987106
LAB Type Physician Office
Facility Name WELLSTAR ACWORTH FAMILY PRACTICE
Street 4550 COBB PARKWAY, NORTH, SUITE 201 A
City ACWORTH
State GA
ZIP 30101
Phone 770 974-4655
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/29/2025
Certificate Expiration Date 5/28/2027
Facility Type Physician Office
Lab Director JOHN N. MURIMI

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