11D1049300 CLIA NUMBER - PEDIATRIC PHYSICIANS PC

Laboratory Demographics

  • CLIA Code: 11D1049300
  • Facility Name: PEDIATRIC PHYSICIANS PC
  • Facility Address: 1111 ALDERMAN DRIVE, SUITE 250
    ALPHARETTA, GA
    ZIP 30005
  • Facility Phone: 678 527-1555
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROY G. BENAROCH
  • NPI Number: 1225229693
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D1049300
LAB Type Physician Office
Facility Name PEDIATRIC PHYSICIANS PC
Street 1111 ALDERMAN DRIVE, SUITE 250
City ALPHARETTA
State GA
ZIP 30005
Phone 678 527-1555
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/3/2024
Certificate Expiration Date 1/2/2026
Facility Type Physician Office
Lab Director ROY G. BENAROCH

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