11D1041184 CLIA NUMBER - PERRY PRIMARY CARE LLC

Laboratory Demographics

  • CLIA Code: 11D1041184
  • Facility Name: PERRY PRIMARY CARE LLC
  • Facility Address: 209 WES PARK DRIVE
    PERRY, GA
    ZIP 31069
  • Facility Phone: 478 987-2578
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KARUNAKER R. SRIPATHI
  • NPI Number: 1083727580
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D1041184
LAB Type Physician Office
Facility Name PERRY PRIMARY CARE LLC
Street 209 WES PARK DRIVE
City PERRY
State GA
ZIP 31069
Phone 478 987-2578
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/25/2025
Certificate Expiration Date 5/24/2027
Facility Type Physician Office
Lab Director KARUNAKER R. SRIPATHI

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