11D1081574 CLIA NUMBER - FOUR CORNERS PRIMARY CARE CENTER

Laboratory Demographics

  • CLIA Code: 11D1081574
  • Facility Name: FOUR CORNERS PRIMARY CARE CENTER
  • Facility Address: 5300 OAKBROOK RARKWAY, BUILDING 100, SUITE 130
    NORCROSS, GA
    ZIP 30093
  • Facility Phone: 770 806-2928
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: DR. DONNA SINCLAIR
  • NPI Number: 1548622285
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D1081574
LAB Type Federally Qualified Health Center
Facility Name FOUR CORNERS PRIMARY CARE CENTER
Street 5300 OAKBROOK RARKWAY, BUILDING 100, SUITE 130
City NORCROSS
State GA
ZIP 30093
Phone 770 806-2928
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/20/2024
Certificate Expiration Date 3/19/2026
Facility Type Federally Qualified Health Center
Lab Director DR. DONNA SINCLAIR

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