11D1017659 CLIA NUMBER - DACULA FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 11D1017659
  • Facility Name: DACULA FAMILY PRACTICE
  • Facility Address: 2850 HOG MOUNTAIN ROAD SUITE 102
    DACULA, GA
    ZIP 30019
  • Facility Phone: 770 614-5454
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAVID J. NAJJAR
  • NPI Number: 1760490742
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D1017659
LAB Type Physician Office
Facility Name DACULA FAMILY PRACTICE
Street 2850 HOG MOUNTAIN ROAD SUITE 102
City DACULA
State GA
ZIP 30019
Phone 770 614-5454
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/1/2025
Certificate Expiration Date 9/30/2027
Facility Type Physician Office
Lab Director DAVID J. NAJJAR

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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