11D1077125 CLIA NUMBER - MEDICO FAMILIAR, INC

Laboratory Demographics

  • CLIA Code: 11D1077125
  • Facility Name: MEDICO FAMILIAR, INC
  • Facility Address: 5345 JIMMY CARTER BOULEVARD SUITE I
    NORCROSS, GA
    ZIP 30093
  • Facility Phone: 770 409-7338
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHAH INAYAT
  • NPI Number: 1154582278
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 11D1077125
LAB Type Physician Office
Facility Name MEDICO FAMILIAR, INC
Street 5345 JIMMY CARTER BOULEVARD SUITE I
City NORCROSS
State GA
ZIP 30093
Phone 770 409-7338
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/3/2023
Certificate Expiration Date 12/2/2025
Facility Type Physician Office
Lab Director SHAH INAYAT

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