11D1054420 CLIA NUMBER - MEDILAG PEDIATRICS PC

Laboratory Demographics

  • CLIA Code: 11D1054420
  • Facility Name: MEDILAG PEDIATRICS PC
  • Facility Address: 605 BEAVER RUIN ROAD SUITE B
    LILBURN, GA
    ZIP 30047
  • Facility Phone: 770 935-0500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BABATUNDE ONASANYA MD
  • NPI Number: 1457565251
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D1054420
LAB Type Physician Office
Facility Name MEDILAG PEDIATRICS PC
Street 605 BEAVER RUIN ROAD SUITE B
City LILBURN
State GA
ZIP 30047
Phone 770 935-0500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/19/2024
Certificate Expiration Date 5/18/2026
Facility Type Physician Office
Lab Director BABATUNDE ONASANYA MD

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