11D1028917 CLIA NUMBER - STAT MEDICAL CARE

Laboratory Demographics

  • CLIA Code: 11D1028917
  • Facility Name: STAT MEDICAL CARE
  • Facility Address: 9690 VENTANA WAY
    JOHNS CREEK, GA
    ZIP 30022
  • Facility Phone: 770 623-6773
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAMES J. DUGAL
  • NPI Number: 1629318662
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D1028917
LAB Type Physician Office
Facility Name STAT MEDICAL CARE
Street 9690 VENTANA WAY
City JOHNS CREEK
State GA
ZIP 30022
Phone 770 623-6773
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/5/2024
Certificate Expiration Date 8/4/2026
Facility Type Physician Office
Lab Director JAMES J. DUGAL

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