11D1046802 CLIA NUMBER - NORTH ATLANTA FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 11D1046802
  • Facility Name: NORTH ATLANTA FAMILY PRACTICE
  • Facility Address: 1400 NORTHSIDE FORSYTH DR STE 240
    CUMMING, GA
    ZIP 30041
  • Facility Phone: 770 344-0877
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SOHEL N. MOMIN
  • NPI Number: 1376994111
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 11D1046802
LAB Type Physician Office
Facility Name NORTH ATLANTA FAMILY PRACTICE
Street 1400 NORTHSIDE FORSYTH DR STE 240
City CUMMING
State GA
ZIP 30041
Phone 770 344-0877
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/19/2025
Certificate Expiration Date 10/18/2027
Facility Type Physician Office
Lab Director SOHEL N. MOMIN

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