11D0993631 CLIA NUMBER - ACWORTH PRIMARY HEALTHCARE

Laboratory Demographics

  • CLIA Code: 11D0993631
  • Facility Name: ACWORTH PRIMARY HEALTHCARE
  • Facility Address: 4465 LEMON STREET
    ACWORTH, GA
    ZIP 30101
  • Facility Phone: 770 529-7478
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HARNISH PATEL
  • NPI Number: 1588826481
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0993631
LAB Type Physician Office
Facility Name ACWORTH PRIMARY HEALTHCARE
Street 4465 LEMON STREET
City ACWORTH
State GA
ZIP 30101
Phone 770 529-7478
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/20/2023
Certificate Expiration Date 11/19/2025
Facility Type Physician Office
Lab Director HARNISH PATEL

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