11D0989805 CLIA NUMBER - JOHN'S CREEK PRIMARY CARE PHYSICIANS LLC

Laboratory Demographics

  • CLIA Code: 11D0989805
  • Facility Name: JOHN'S CREEK PRIMARY CARE PHYSICIANS LLC
  • Facility Address: 4365 JOHNS CREEK PARKWAY, SUITE 400
    SUWANEE, GA
    ZIP 30024
  • Facility Phone: 678 957-1910
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LEE E. HERMAN
  • NPI Number: 1790822583
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0989805
LAB Type Physician Office
Facility Name JOHN'S CREEK PRIMARY CARE PHYSICIANS LLC
Street 4365 JOHNS CREEK PARKWAY, SUITE 400
City SUWANEE
State GA
ZIP 30024
Phone 678 957-1910
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/9/2024
Certificate Expiration Date 11/8/2026
Facility Type Physician Office
Lab Director LEE E. HERMAN

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