11D1018085 CLIA NUMBER - BUFORD CARE INCORPORATE

Laboratory Demographics

  • CLIA Code: 11D1018085
  • Facility Name: BUFORD CARE INCORPORATE
  • Facility Address: 2721 BUFORD HIGHWAY
    BUFORD, GA
    ZIP 30518
  • Facility Phone: 770 945-4800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MOHSEN KHODAKARAM
  • NPI Number: 1154504751
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D1018085
LAB Type Physician Office
Facility Name BUFORD CARE INCORPORATE
Street 2721 BUFORD HIGHWAY
City BUFORD
State GA
ZIP 30518
Phone 770 945-4800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/14/2025
Certificate Expiration Date 10/13/2027
Facility Type Physician Office
Lab Director MOHSEN KHODAKARAM

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