11D1055186 CLIA NUMBER - MERCY INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 11D1055186
  • Facility Name: MERCY INTERNAL MEDICINE
  • Facility Address: 8225 MALL PARKWAY, SUITE 240
    LITHONIA, GA
    ZIP 30038
  • Facility Phone: 770 484-3092
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: OLUFUNSO A. OJO
  • NPI Number: 1710038856
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D1055186
LAB Type Physician Office
Facility Name MERCY INTERNAL MEDICINE
Street 8225 MALL PARKWAY, SUITE 240
City LITHONIA
State GA
ZIP 30038
Phone 770 484-3092
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/12/2024
Certificate Expiration Date 6/11/2026
Facility Type Physician Office
Lab Director OLUFUNSO A. OJO

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