11D1062906 CLIA NUMBER - WELLNESS PRIMARYCARE, LLC

Laboratory Demographics

  • CLIA Code: 11D1062906
  • Facility Name: WELLNESS PRIMARYCARE, LLC
  • Facility Address: 5456 JIMMY CARTER BOULEVARD, SUITE 240
    NORCROSS, GA
    ZIP 30093
  • Facility Phone: 678 380-9889
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: PAUL H. NGUYEN MD
  • NPI Number: 1124291927
  • Taxonomy: 171M00000X - Case Manager/Care Coordinator

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CLIA Record

Field Name Field Value
CLIA Number 11D1062906
LAB Type Physician Office
Facility Name WELLNESS PRIMARYCARE, LLC
Street 5456 JIMMY CARTER BOULEVARD, SUITE 240
City NORCROSS
State GA
ZIP 30093
Phone 678 380-9889
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 12/29/2024
Certificate Expiration Date 12/28/2026
Facility Type Physician Office
Lab Director PAUL H. NGUYEN MD

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