11D1003936 CLIA NUMBER - CONCENTRA MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 11D1003936
  • Facility Name: CONCENTRA MEDICAL CENTER
  • Facility Address: 6475 JIMMY CARTER BOULEVARD, SUITE 200
    NORCROSS, GA
    ZIP 30071
  • Facility Phone: 770 242-7744
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CECILLY PRATT
  • NPI Number: 1629267349
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D1003936
LAB Type Physician Office
Facility Name CONCENTRA MEDICAL CENTER
Street 6475 JIMMY CARTER BOULEVARD, SUITE 200
City NORCROSS
State GA
ZIP 30071
Phone 770 242-7744
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/11/2024
Certificate Expiration Date 11/10/2026
Facility Type Physician Office
Lab Director CECILLY PRATT

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This page was last updated on: 6/4/2025