11D1006094 CLIA NUMBER - CLIFFORD FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 11D1006094
  • Facility Name: CLIFFORD FAMILY PRACTICE
  • Facility Address: 1355 CHURCH STREET EXT, SUITE G
    MARIETTA, GA
    ZIP 30060
  • Facility Phone: 770 422-3232
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAVID M. CLIFFORD
  • NPI Number: 1023295730
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D1006094
LAB Type Physician Office
Facility Name CLIFFORD FAMILY PRACTICE
Street 1355 CHURCH STREET EXT, SUITE G
City MARIETTA
State GA
ZIP 30060
Phone 770 422-3232
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/7/2024
Certificate Expiration Date 11/6/2026
Facility Type Physician Office
Lab Director DAVID M. CLIFFORD

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