11D0990582 CLIA NUMBER - FIRST FOUNDATION MEDICAL CLINIC PC

Laboratory Demographics

  • CLIA Code: 11D0990582
  • Facility Name: FIRST FOUNDATION MEDICAL CLINIC PC
  • Facility Address: 2930 HORIZON PARK DRIVE, SUITE C
    SUWANEE, GA
    ZIP 30024
  • Facility Phone: (678) 546-2840
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JULIUS O. AJAYI
  • NPI Number: 1306858337
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0990582
LAB Type Physician Office
Facility Name FIRST FOUNDATION MEDICAL CLINIC PC
Street 2930 HORIZON PARK DRIVE, SUITE C
City SUWANEE
State GA
ZIP 30024
Phone 6785462840
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 8/27/2025
Certificate Expiration Date 8/26/2027
Facility Type Physician Office
Lab Director JULIUS O. AJAYI

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This page was last updated on: 5/18/2026