11D1050147 CLIA NUMBER - RIVER PARC INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 11D1050147
  • Facility Name: RIVER PARC INTERNAL MEDICINE
  • Facility Address: 4855 RIVER GREEN PARKWAY, SUITE 140
    DULUTH, GA
    ZIP 30096
  • Facility Phone: 678 417-0077
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: YOUNG W. KANG
  • NPI Number: 1912366931
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D1050147
LAB Type Physician Office
Facility Name RIVER PARC INTERNAL MEDICINE
Street 4855 RIVER GREEN PARKWAY, SUITE 140
City DULUTH
State GA
ZIP 30096
Phone 678 417-0077
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/26/2024
Certificate Expiration Date 1/25/2026
Facility Type Physician Office
Lab Director YOUNG W. KANG

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