11D1047865 CLIA NUMBER - WICKSHIRE BUFORD OPCO, LLC

Laboratory Demographics

  • CLIA Code: 11D1047865
  • Facility Name: WICKSHIRE BUFORD OPCO, LLC
  • Facility Address: 4355 SOUTH LEE STREET
    BUFORD, GA
    ZIP 30518
  • Facility Phone: 615 942-0240
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: TRACY GRIFFITH
  • NPI Number: 1750989687
  • Taxonomy: 310400000X - Assisted Living Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D1047865
LAB Type Assisted Living Facility
Facility Name WICKSHIRE BUFORD OPCO, LLC
Street 4355 SOUTH LEE STREET
City BUFORD
State GA
ZIP 30518
Phone 615 942-0240
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/16/2023
Certificate Expiration Date 11/15/2025
Facility Type Assisted Living Facility
Lab Director TRACY GRIFFITH

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