11D1072076 CLIA NUMBER - HEALTHSTAR FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 11D1072076
  • Facility Name: HEALTHSTAR FAMILY MEDICINE
  • Facility Address: 4485 TENCH ROAD SUITE 120
    SUWANEE, GA
    ZIP 30024
  • Facility Phone: 678 294-3575
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: USHA MUSUNURU
  • NPI Number: 1497953582
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D1072076
LAB Type Physician Office
Facility Name HEALTHSTAR FAMILY MEDICINE
Street 4485 TENCH ROAD SUITE 120
City SUWANEE
State GA
ZIP 30024
Phone 678 294-3575
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 8/8/2025
Certificate Expiration Date 8/7/2027
Facility Type Physician Office
Lab Director USHA MUSUNURU

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