11D1074167 CLIA NUMBER - AGA LLC

Laboratory Demographics

  • CLIA Code: 11D1074167
  • Facility Name: AGA LLC
  • Facility Address: 3886 PRINCETON LAKES WAY SUITE 240
    ATLANTA, GA
    ZIP 30331
  • Facility Phone: 404 881-1094
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NICOLE GORDON
  • NPI Number: 1124064118
  • Taxonomy: 207RG0100X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D1074167
LAB Type Physician Office
Facility Name AGA LLC
Street 3886 PRINCETON LAKES WAY SUITE 240
City ATLANTA
State GA
ZIP 30331
Phone 404 881-1094
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/25/2025
Certificate Expiration Date 9/24/2027
Facility Type Physician Office
Lab Director NICOLE GORDON

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