11D1070744 CLIA NUMBER - PRIMECARE PEDIATRICS PC

Laboratory Demographics

  • CLIA Code: 11D1070744
  • Facility Name: PRIMECARE PEDIATRICS PC
  • Facility Address: 15A BAYNARD PARK
    NEWNAN, GA
    ZIP 30265
  • Facility Phone: 770 251-5253
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: FRED A. TEGA
  • NPI Number: 1396905907
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D1070744
LAB Type Physician Office
Facility Name PRIMECARE PEDIATRICS PC
Street 15A BAYNARD PARK
City NEWNAN
State GA
ZIP 30265
Phone 770 251-5253
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 10/27/2023
Certificate Expiration Date 10/26/2025
Facility Type Physician Office
Lab Director FRED A. TEGA

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