11D1056052 CLIA NUMBER - ALPHACARE MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 11D1056052
  • Facility Name: ALPHACARE MEDICAL CENTER
  • Facility Address: 1865 LOCKEWAY DRIVE, SUITE 603
    ALPHARETTA, GA
    ZIP 30004
  • Facility Phone: 770 752-8499
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARIAM L. LATIF
  • NPI Number: 1578530325
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D1056052
LAB Type Physician Office
Facility Name ALPHACARE MEDICAL CENTER
Street 1865 LOCKEWAY DRIVE, SUITE 603
City ALPHARETTA
State GA
ZIP 30004
Phone 770 752-8499
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/5/2024
Certificate Expiration Date 7/4/2026
Facility Type Physician Office
Lab Director MARIAM L. LATIF

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This page was last updated on: 3/20/2025